Provider Demographics
NPI:1841066925
Name:A NEW LIFE COUNSELING 365 LLC
Entity type:Organization
Organization Name:A NEW LIFE COUNSELING 365 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:NITZA
Authorized Official - Middle Name:NIDIA
Authorized Official - Last Name:SANTIAGO ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:863-608-9854
Mailing Address - Street 1:2730 BIG TIMBER DR FL 34758
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34758-2513
Mailing Address - Country:US
Mailing Address - Phone:863-608-9854
Mailing Address - Fax:
Practice Address - Street 1:2730 BIG TIMBER DR FL 34758
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34758-2513
Practice Address - Country:US
Practice Address - Phone:863-608-9854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)