Provider Demographics
NPI:1366685661
Name:PROFESSIONAL COUNSELING CONSULTING & HUMAN SERVICES LLC
Entity Type:Organization
Organization Name:PROFESSIONAL COUNSELING CONSULTING & HUMAN SERVICES LLC
Other - Org Name:NEW BEGINNINGS CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAHEEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-264-7024
Mailing Address - Street 1:1851 W END AVE
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-2050
Mailing Address - Country:US
Mailing Address - Phone:570-622-9101
Mailing Address - Fax:570-622-9102
Practice Address - Street 1:1851 W END AVE
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-2050
Practice Address - Country:US
Practice Address - Phone:570-622-9101
Practice Address - Fax:570-622-9102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-16
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & AdolescentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022698110007Medicaid
PA1N9295OtherMEDICARE