Provider Demographics
NPI:1518092212
Name:COMMUNITY MENTAL HEALTH
Entity Type:Organization
Organization Name:COMMUNITY MENTAL HEALTH
Other - Org Name:NEW BEGINNINGS CHRISTIAN COUNSELING CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC OWNER AND DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SUNLEY
Authorized Official - Suffix:
Authorized Official - Credentials:CMFT
Authorized Official - Phone:210-697-8191
Mailing Address - Street 1:28116 ROYAL ASCOT
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS RANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78015
Mailing Address - Country:US
Mailing Address - Phone:210-854-9819
Mailing Address - Fax:210-494-9466
Practice Address - Street 1:1380 PANTHEON WAY
Practice Address - Street 2:#310
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232
Practice Address - Country:US
Practice Address - Phone:210-697-8191
Practice Address - Fax:210-494-9466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
21C90 CERTIFICATION#101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty