Basic Information
| Provider Information | |||||||||
| NPI: | 1972808954 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NEW BEGINNINGS COUNSELING SERVICE | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 6200 AURORA AVE STE 103E | ||||||||
| Address2: | |||||||||
| City: | URBANDALE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503226338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5154016886 | ||||||||
| FaxNumber: | 5158832692 | ||||||||
| Practice Location | |||||||||
| Address1: | 6200 AURORA AVE STE 103E | ||||||||
| Address2: | |||||||||
| City: | URBANDALE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503226338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5154016886 | ||||||||
| FaxNumber: | 5158832692 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/21/2011 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | BREDICE | ||||||||
| AuthorizedOfficialFirstName: | SUSIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF OPERATING OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 5154508908 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.