Provider Demographics
NPI:1720845779
Name:NUEVO CAMINO COUNSELING LLC
Entity Type:Organization
Organization Name:NUEVO CAMINO COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:HANLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-545-4440
Mailing Address - Street 1:732 MONTGOMERY HWY
Mailing Address - Street 2:PMB 221
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1208 GARDENS PL
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35216-6157
Practice Address - Country:US
Practice Address - Phone:205-545-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)