Provider Demographics
NPI:1851171482
Name:FRESHNUBEGINNINGSLLC
Entity Type:Organization
Organization Name:FRESHNUBEGINNINGSLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:JOHNSON-KING
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-R
Authorized Official - Phone:804-591-8671
Mailing Address - Street 1:2308 COURTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-1739
Mailing Address - Country:US
Mailing Address - Phone:804-591-8671
Mailing Address - Fax:866-622-7868
Practice Address - Street 1:4000 SOLERA DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-4092
Practice Address - Country:US
Practice Address - Phone:804-591-8671
Practice Address - Fax:866-622-7868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health