Provider Demographics
NPI:1134307101
Name:NEW DESTINY COMMUNITY COUNSELING CENTER
Entity Type:Organization
Organization Name:NEW DESTINY COMMUNITY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-246-8850
Mailing Address - Street 1:1330 LIVINGSTON AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-3828
Mailing Address - Country:US
Mailing Address - Phone:732-246-8850
Mailing Address - Fax:732-246-8852
Practice Address - Street 1:1330 LIVINGSTON AVE STE 5
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-3828
Practice Address - Country:US
Practice Address - Phone:732-246-8850
Practice Address - Fax:732-246-8852
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW DESTINY FAMILY WORSHIP CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty