Provider Demographics
NPI:1487202743
Name:NEW BEGINNINGS COUNSELING LLC
Entity Type:Organization
Organization Name:NEW BEGINNINGS COUNSELING LLC
Other - Org Name:NEW BEGINNINGS COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MENTAL HEALTH PROFESSIONAL
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HEITZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LICSW
Authorized Official - Phone:218-999-7081
Mailing Address - Street 1:104 NE 3RD ST # 200H
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-2869
Mailing Address - Country:US
Mailing Address - Phone:218-999-7081
Mailing Address - Fax:
Practice Address - Street 1:104 NE 3RD ST # 200H
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-2869
Practice Address - Country:US
Practice Address - Phone:218-259-5566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-29
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1780871418Medicaid