Provider Demographics
NPI:1568513596
Name:NEW HOPE CHRISTIAN COUNSELING, INC
Entity Type:Organization
Organization Name:NEW HOPE CHRISTIAN COUNSELING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:SIEMIENKIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:ACSW
Authorized Official - Phone:231-529-4673
Mailing Address - Street 1:PO BOX 525
Mailing Address - Street 2:
Mailing Address - City:BRUTUS
Mailing Address - State:MI
Mailing Address - Zip Code:49716-0525
Mailing Address - Country:US
Mailing Address - Phone:231-529-4673
Mailing Address - Fax:231-529-4613
Practice Address - Street 1:6396 BRUTUS ROAD
Practice Address - Street 2:
Practice Address - City:BRUTUS
Practice Address - State:MI
Practice Address - Zip Code:49716-0525
Practice Address - Country:US
Practice Address - Phone:231-529-4673
Practice Address - Fax:231-529-4613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010193571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI044850OtherVALUE OPTIONS
MI0007323067OtherAETNA