Provider Demographics
NPI:1740929280
Name:A NEW BREATHE OF LIFE COUNSELING & CONSULTING, LLC
Entity type:Organization
Organization Name:A NEW BREATHE OF LIFE COUNSELING & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BONNEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEALS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CSAC, ICS, NCC
Authorized Official - Phone:262-290-3315
Mailing Address - Street 1:3235 N 124TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-3126
Mailing Address - Country:US
Mailing Address - Phone:262-290-3315
Mailing Address - Fax:262-458-4099
Practice Address - Street 1:3235 N 124TH ST STE 1
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-3126
Practice Address - Country:US
Practice Address - Phone:262-290-3315
Practice Address - Fax:262-458-4099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health