Provider Demographics
NPI:1639609555
Name:NEW BEGINNINGS BEHAVIORAL COUNSELING,LLC
Entity Type:Organization
Organization Name:NEW BEGINNINGS BEHAVIORAL COUNSELING,LLC
Other - Org Name:NEW BEGINNINGS BEHAVIORAL COUNSELING,LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:POTTS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:229-726-6130
Mailing Address - Street 1:P. O. BOX 681
Mailing Address - Street 2:
Mailing Address - City:LOVE JOY
Mailing Address - State:GA
Mailing Address - Zip Code:30250-9998
Mailing Address - Country:US
Mailing Address - Phone:229-449-8977
Mailing Address - Fax:678-759-8029
Practice Address - Street 1:9456 S MAIN ST STE E2
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236
Practice Address - Country:US
Practice Address - Phone:229-726-6130
Practice Address - Fax:678-759-8029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-13
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0059911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1639609555Medicaid
GA1932464658Medicaid