Provider Demographics
NPI: | 1700305067 |
---|---|
Name: | NEW DAWN COUNSELING, LLC |
Entity Type: | Organization |
Organization Name: | NEW DAWN COUNSELING, LLC |
Other - Org Name: | REPRODUCTIVE JOURNEY COUNSELING AND SUPPORT |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MARY |
Authorized Official - Middle Name: | SUSANNAH |
Authorized Official - Last Name: | BALDWIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPC |
Authorized Official - Phone: | 864-513-1844 |
Mailing Address - Street 1: | 25 WOODS LAKE RD STE 712 |
Mailing Address - Street 2: | |
Mailing Address - City: | GREENVILLE |
Mailing Address - State: | SC |
Mailing Address - Zip Code: | 29607-2765 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 864-242-0005 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 25 WOODS LAKE RD STE 712 |
Practice Address - Street 2: | |
Practice Address - City: | GREENVILLE |
Practice Address - State: | SC |
Practice Address - Zip Code: | 29607-2765 |
Practice Address - Country: | US |
Practice Address - Phone: | 864-242-0005 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-09-18 |
Last Update Date: | 2018-03-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Single Specialty |