Provider Demographics
NPI:1710746847
Name:NEW LIFE COUNSELING AND CONSULTING, LLC
Entity Type:Organization
Organization Name:NEW LIFE COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR/OWN
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOONE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:601-672-7505
Mailing Address - Street 1:2102 CROSSBRIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:BYRAM
Mailing Address - State:MS
Mailing Address - Zip Code:39272-8716
Mailing Address - Country:US
Mailing Address - Phone:601-672-7505
Mailing Address - Fax:
Practice Address - Street 1:2102 CROSSBRIDGE BLVD
Practice Address - Street 2:
Practice Address - City:BYRAM
Practice Address - State:MS
Practice Address - Zip Code:39272-8716
Practice Address - Country:US
Practice Address - Phone:601-672-7505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)