Basic Information
| Provider Information | |||||||||
| NPI: | 1720578636 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW BEGINNINGS ADDICTION & COUNSELING SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 29328 PERTH ST | ||||||||
| Address2: | |||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481544562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344543570 | ||||||||
| FaxNumber: | 7342075326 | ||||||||
| Practice Location | |||||||||
| Address1: | 27677 PROFESSIONAL CENTER DRIVE SUITE 135 | ||||||||
| Address2: | |||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344543570 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2018 | ||||||||
| LastUpdateDate: | 05/16/2018 | ||||||||
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| AuthorizedOfficialLastName: | SIMKO | ||||||||
| AuthorizedOfficialFirstName: | PATRICIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | LPC/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7344543570 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LPC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 6401007152 | MI | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.