Provider Demographics
NPI:1669994158
Name:NEW CREATION COUNSELING LLC
Entity type:Organization
Organization Name:NEW CREATION COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:AHLGREN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:321-735-8113
Mailing Address - Street 1:503 SOUTH PALM AVE.
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796
Mailing Address - Country:US
Mailing Address - Phone:321-735-8113
Mailing Address - Fax:833-921-0180
Practice Address - Street 1:503 SOUTH PALM AVE.
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796
Practice Address - Country:US
Practice Address - Phone:321-735-8113
Practice Address - Fax:833-921-0180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-17
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW130701041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty