Provider Demographics
NPI:1962095778
Name:NEW CREATION COUNSELING & CONSULTING SERVICES, LLC
Entity type:Organization
Organization Name:NEW CREATION COUNSELING & CONSULTING SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WILKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-456-9068
Mailing Address - Street 1:1301 NW 85TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-1623
Mailing Address - Country:US
Mailing Address - Phone:405-456-9068
Mailing Address - Fax:
Practice Address - Street 1:1301 NW 85TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-1623
Practice Address - Country:US
Practice Address - Phone:405-456-9068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty