Basic Information
| Provider Information | |||||||||
| NPI: | 1023605334 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANEW BEHAVIORAL HEALTH LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 372 WEST ST STE 102 | ||||||||
| Address2: | |||||||||
| City: | KEENE | ||||||||
| State: | NH | ||||||||
| PostalCode: | 034312412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6033380033 | ||||||||
| FaxNumber: | 8004807578 | ||||||||
| Practice Location | |||||||||
| Address1: | 372 WEST ST STE 102 | ||||||||
| Address2: | |||||||||
| City: | KEENE | ||||||||
| State: | NH | ||||||||
| PostalCode: | 034312412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6033380033 | ||||||||
| FaxNumber: | 8004807578 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2020 | ||||||||
| LastUpdateDate: | 04/29/2022 | ||||||||
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| AuthorizedOfficialLastName: | PRATT | ||||||||
| AuthorizedOfficialFirstName: | BRITTANY | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 6033380033 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 103TA0400X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Addiction (Substance Use Disorder) | 103TP2701X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy | 261QM0801X | N | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | 261QR0405X | N | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | 1041C0700X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.