Provider Demographics
NPI:1689058646
Name:NEW LIFE COUNSELING CENTER
Entity Type:Organization
Organization Name:NEW LIFE COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REKETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:336-816-2389
Mailing Address - Street 1:204 MUIRS CHAPEL RD
Mailing Address - Street 2:STE 305
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-6173
Mailing Address - Country:US
Mailing Address - Phone:336-816-2389
Mailing Address - Fax:336-542-2885
Practice Address - Street 1:204 MUIRS CHAPEL RD
Practice Address - Street 2:STE 305
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-6173
Practice Address - Country:US
Practice Address - Phone:336-816-2389
Practice Address - Fax:336-542-2885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-18
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7646251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health