Provider Demographics
NPI:1841597739
Name:NEW LIFE COUNSELING CENTER, INC
Entity Type:Organization
Organization Name:NEW LIFE COUNSELING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:815-356-9683
Mailing Address - Street 1:600 DAKOTA ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60012-3742
Mailing Address - Country:US
Mailing Address - Phone:815-356-9683
Mailing Address - Fax:815-356-8975
Practice Address - Street 1:600 DAKOTA ST
Practice Address - Street 2:SUITE B
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60012-3742
Practice Address - Country:US
Practice Address - Phone:815-356-9683
Practice Address - Fax:815-356-8975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-11
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health