Provider Demographics
NPI:1952511586
Name:NEW CREATION COUNSELING
Entity Type:Organization
Organization Name:NEW CREATION COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:916-787-8717
Mailing Address - Street 1:2140 PROFESSIONAL DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3734
Mailing Address - Country:US
Mailing Address - Phone:916-787-8717
Mailing Address - Fax:916-787-5616
Practice Address - Street 1:2140 PROFESSIONAL DR
Practice Address - Street 2:SUITE 205
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3734
Practice Address - Country:US
Practice Address - Phone:916-787-8717
Practice Address - Fax:916-787-5616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9406106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty