Provider Demographics
NPI:1790415578
Name:NEW LIFE ADDICTION COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:NEW LIFE ADDICTION COUNSELING SERVICES, INC.
Other - Org Name:DISCOVERY MD, WHITEMARSH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUMSHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-255-4475
Mailing Address - Street 1:7240 PARKWAY DR STE 140
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1367
Mailing Address - Country:US
Mailing Address - Phone:410-255-4475
Mailing Address - Fax:
Practice Address - Street 1:8114 SANDPIPER CIR STE 213-215
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-4934
Practice Address - Country:US
Practice Address - Phone:410-255-4475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty