Provider Demographics
NPI:1497065965
Name:NEW BEGINNINGS COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:NEW BEGINNINGS COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STACIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-893-5938
Mailing Address - Street 1:201 S EMERSON AVE
Mailing Address - Street 2:STE. 120
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1915
Mailing Address - Country:US
Mailing Address - Phone:317-893-5938
Mailing Address - Fax:317-893-4347
Practice Address - Street 1:201 S EMERSON AVE
Practice Address - Street 2:STE. 120
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1915
Practice Address - Country:US
Practice Address - Phone:317-893-5938
Practice Address - Fax:317-893-4347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200999640AMedicaid