Provider Demographics
NPI:1619490299
Name:NEW LIFE COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:NEW LIFE COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FINCH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:985-632-7797
Mailing Address - Street 1:PO BOX 1145
Mailing Address - Street 2:
Mailing Address - City:LAROSE
Mailing Address - State:LA
Mailing Address - Zip Code:70373-1145
Mailing Address - Country:US
Mailing Address - Phone:985-632-7797
Mailing Address - Fax:985-632-7797
Practice Address - Street 1:14758 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CUT OFF
Practice Address - State:LA
Practice Address - Zip Code:70345-3302
Practice Address - Country:US
Practice Address - Phone:985-632-7797
Practice Address - Fax:985-632-7797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALPC5823101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty