Provider Demographics
NPI:1659879500
Name:NEW PATHS COUNSELING AND RECOVERY SERVICES
Entity Type:Organization
Organization Name:NEW PATHS COUNSELING AND RECOVERY SERVICES
Other - Org Name:NEW PATHS COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:MLADC
Authorized Official - Phone:603-670-5557
Mailing Address - Street 1:45 CANTON ST
Mailing Address - Street 2:3F
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3563
Mailing Address - Country:US
Mailing Address - Phone:603-670-5557
Mailing Address - Fax:
Practice Address - Street 1:25 LOWELL ST STE 203
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1647
Practice Address - Country:US
Practice Address - Phone:603-670-5557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0954251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3103753Medicaid