Provider Demographics
NPI:1245607514
Name:NEW HOPE COUNSELING AND WELLNESS LLC
Entity Type:Organization
Organization Name:NEW HOPE COUNSELING AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER- FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:KATHRYN
Authorized Official - Last Name:GUNDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-412-2403
Mailing Address - Street 1:609 S NEW HOPE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-4825
Mailing Address - Country:US
Mailing Address - Phone:704-208-1865
Mailing Address - Fax:
Practice Address - Street 1:609 S NEW HOPE RD STE 102
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-4825
Practice Address - Country:US
Practice Address - Phone:704-208-1865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-21
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11512101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1245607514Medicaid