New Life Counseling and Mental Health Services, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

NEW LIFE COUNSELING AND MENTAL HEALTH SERVICES, LLC

Practice address

12 Prospect St
Bloomfield, NJ 07003-3211

Phone

(973) 748-0847

Fax

(973) 259-3706

NPI assigned

Jan 24, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Charles Idris Webb, LCSW

Title

Co-Owner

Phone

(973) 748-0847

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516838400000",
    "number": "1194223271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 PROSPECT ST",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033211",
            "telephone_number": "973-748-0847",
            "fax_number": "973-259-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 PROSPECT ST",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033211",
            "telephone_number": "973-748-0847",
            "fax_number": "973-259-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE COUNSELING AND MENTAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-24",
        "last_updated": "2018-01-25",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "IDRIS",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "973-748-0847",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0457019",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0457671",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Bloomfield, NJ
• Providers in Bloomfield, NJ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.