Provider Demographics
NPI:1275679177
Name:NEW LIFE COUNSELING, INC
Entity Type:Organization
Organization Name:NEW LIFE COUNSELING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:IZABELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORIVODSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:LLMSW
Authorized Official - Phone:248-875-3661
Mailing Address - Street 1:30500 NORTHWESTERN HWY
Mailing Address - Street 2:316
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48390-3178
Mailing Address - Country:US
Mailing Address - Phone:248-875-3661
Mailing Address - Fax:
Practice Address - Street 1:30500 NORTHWESTERN HWY
Practice Address - Street 2:316B
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3178
Practice Address - Country:US
Practice Address - Phone:248-875-3661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801085997251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management