Provider Demographics
NPI:1831930908
Name:NU GENERATION MENTAL HEALTH SERVICES, PLLC
Entity type:Organization
Organization Name:NU GENERATION MENTAL HEALTH SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:LATIL
Authorized Official - Last Name:BURNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:540-278-3666
Mailing Address - Street 1:215 OLD TREYBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-8145
Mailing Address - Country:US
Mailing Address - Phone:540-278-3666
Mailing Address - Fax:
Practice Address - Street 1:717 GREEN VALLEY RD STE 200
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-2156
Practice Address - Country:US
Practice Address - Phone:540-278-3666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)