Provider Demographics
NPI:1689727505
Name:NEW BEGINNINGS PSYCHOLOGICAL SERVICES PC
Entity Type:Organization
Organization Name:NEW BEGINNINGS PSYCHOLOGICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KENWORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-279-8866
Mailing Address - Street 1:PO BOX 466
Mailing Address - Street 2:NEW BEGINNINGS PSYCHOLOGICAL SERVICES
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068
Mailing Address - Country:US
Mailing Address - Phone:517-279-8866
Mailing Address - Fax:517-924-1816
Practice Address - Street 1:694 W CHICAGO RD
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-8405
Practice Address - Country:US
Practice Address - Phone:517-279-8866
Practice Address - Fax:517-924-1816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301010654103T00000X
MI6301009114103T00000X
MI6801058469104100000X
MI6801084214104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty