Provider Demographics
NPI:1437645785
Name:NEW LIFE COUNSELING, LLC
Entity Type:Organization
Organization Name:NEW LIFE COUNSELING, LLC
Other - Org Name:MONARCH COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:
Authorized Official - Last Name:VISLOCKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-426-3453
Mailing Address - Street 1:1301 SHILOH RD NW STE 450
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-7152
Mailing Address - Country:US
Mailing Address - Phone:404-426-3453
Mailing Address - Fax:
Practice Address - Street 1:1301 SHILOH RD NW STE 450
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-7152
Practice Address - Country:US
Practice Address - Phone:404-426-3453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-10
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0044241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty