Provider Demographics
NPI:1538300470
Name:NEW LIFE COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:NEW LIFE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUDSON
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BUCKWALTER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:717-653-1507
Mailing Address - Street 1:410 S ANGLE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT JOY
Mailing Address - State:PA
Mailing Address - Zip Code:17552-2031
Mailing Address - Country:US
Mailing Address - Phone:717-653-1507
Mailing Address - Fax:717-653-1527
Practice Address - Street 1:410 S ANGLE ST
Practice Address - Street 2:
Practice Address - City:MOUNT JOY
Practice Address - State:PA
Practice Address - Zip Code:17552-2031
Practice Address - Country:US
Practice Address - Phone:717-653-1507
Practice Address - Fax:717-653-1527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-23
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW008604L251S00000X
PAPS007512L251S00000X
PAPC004288251S00000X
PAPC007789251S00000X
PAPC007826251S00000X
PAPC004702251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health