Provider Demographics
NPI:1821238080
Name:A NEW BEGINNING COUNSELING CENTER, PC.
Entity Type:Organization
Organization Name:A NEW BEGINNING COUNSELING CENTER, PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OFFICE MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:SHAKESPEARE
Authorized Official - Last Name:NEIGHBORS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-412-7740
Mailing Address - Street 1:815 S BRIDGE WAY PL
Mailing Address - Street 2:SUITE 118
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-6006
Mailing Address - Country:US
Mailing Address - Phone:208-412-7740
Mailing Address - Fax:208-853-1318
Practice Address - Street 1:815 S BRIDGE WAY PL
Practice Address - Street 2:SUITE 118
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-6006
Practice Address - Country:US
Practice Address - Phone:208-412-7740
Practice Address - Fax:208-853-1318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-01
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW - 28825251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health