Provider Demographics
NPI:1871509687
Name:NEW LIFE SOLUTIONS LLC
Entity Type:Organization
Organization Name:NEW LIFE SOLUTIONS LLC
Other - Org Name:LLC SOLE MEMBER
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD PSYD
Authorized Official - Phone:305-558-1500
Mailing Address - Street 1:7850 NW 146 ST
Mailing Address - Street 2:STE 422
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016
Mailing Address - Country:US
Mailing Address - Phone:305-558-1500
Mailing Address - Fax:305-558-6838
Practice Address - Street 1:7850 NW 146 ST
Practice Address - Street 2:STE 422
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016
Practice Address - Country:US
Practice Address - Phone:305-558-1500
Practice Address - Fax:305-558-6838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6483103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPY6483OtherPSYCHOLOGIST
FLPY6483OtherPSYCHOLOGIST
P64153Medicare UPIN