Provider Demographics
NPI:1780141713
Name:NEW LIFE COUNSELING LLC
Entity type:Organization
Organization Name:NEW LIFE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONDRA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHP, MSW
Authorized Official - Phone:402-519-0054
Mailing Address - Street 1:702 W KOENIG ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-6556
Mailing Address - Country:US
Mailing Address - Phone:402-519-0054
Mailing Address - Fax:308-384-1987
Practice Address - Street 1:702 W KOENIG ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-6556
Practice Address - Country:US
Practice Address - Phone:402-519-0054
Practice Address - Fax:308-384-1987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1417391640OtherINDIVIDUAL NPI