Provider Demographics
NPI:1831447689
Name:NEW LIFE COUNSELING CENTER, PLLC
Entity type:Organization
Organization Name:NEW LIFE COUNSELING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:WILSON
Authorized Official - Last Name:MCDILL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:512-964-3653
Mailing Address - Street 1:3000 JOE DIMAGGIO BLVD STE 88
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-3992
Mailing Address - Country:US
Mailing Address - Phone:512-238-1700
Mailing Address - Fax:512-255-0090
Practice Address - Street 1:3000 JOE DIMAGGIO BLVD STE 88
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-3992
Practice Address - Country:US
Practice Address - Phone:512-238-1700
Practice Address - Fax:512-255-0090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty