Provider Demographics
NPI:1194196873
Name:NEW GROWTH BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:NEW GROWTH BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON-BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MS, LMHP/RC
Authorized Official - Phone:804-982-3107
Mailing Address - Street 1:5825 QUIET PINE CIR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-7731
Mailing Address - Country:US
Mailing Address - Phone:804-243-4912
Mailing Address - Fax:
Practice Address - Street 1:5825 QUIET PINE CIR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-7731
Practice Address - Country:US
Practice Address - Phone:804-243-4912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2598251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health