Provider Demographics
NPI:1053158188
Name:NEW LIFE COUNSELING
Entity type:Organization
Organization Name:NEW LIFE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:COHEN
Authorized Official - Last Name:CONNER
Authorized Official - Suffix:SR
Authorized Official - Credentials:LCMHC / LCAS
Authorized Official - Phone:252-241-7395
Mailing Address - Street 1:108 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28570-9010
Mailing Address - Country:US
Mailing Address - Phone:252-241-7395
Mailing Address - Fax:252-557-8208
Practice Address - Street 1:1185 HIBBS RD
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:NC
Practice Address - Zip Code:28570-9129
Practice Address - Country:US
Practice Address - Phone:252-241-7395
Practice Address - Fax:252-557-8208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health