Provider Demographics
NPI:1336578442
Name:NEW BEGINNINGS COUNSELING GROUP
Entity Type:Organization
Organization Name:NEW BEGINNINGS COUNSELING GROUP
Other - Org Name:NEW BEGINNINGS COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO/COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CRADC, CS, COO
Authorized Official - Phone:660-562-3000
Mailing Address - Street 1:423 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64468-1614
Mailing Address - Country:US
Mailing Address - Phone:660-562-3000
Mailing Address - Fax:660-562-3002
Practice Address - Street 1:423 N MARKET ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:MO
Practice Address - Zip Code:64468
Practice Address - Country:US
Practice Address - Phone:660-562-3000
Practice Address - Fax:660-562-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-08
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO6559101YA0400X
MO2013037934104100000X, 104100000X
MO1999140256103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1154671311Medicaid
MO1629336177Medicaid
MO1336587575Medicaid