NPIMap

Organization Active NPI

New Life Addiction Counseling

  • Clinical Social Worker
  • Hanover, MD
National Provider Identifier
1235566373
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC2259 Issued in MD
Legal business name
NEW LIFE ADDICTION COUNSELING
Doing business as
DiscoveryMD, Hanover
Practice address
7240 Parkway Dr Ste 140
Hanover, MD 21076-1367
Phone
(714) 828-1800
Fax
(714) 882-1186
NPI assigned
Oct 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Authorized official

Name
Magdalen Gustilo
Title
Director of Payer Relations
Phone
(714) 568-7667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X LC2259 MD Primary

Addresses

Primary practice location

7240 Parkway Dr Ste 140
Hanover, MD 21076-1367

Mailing address

18401 Von Karman Ave Ste 500
Irvine, CA 92612-8531
Phone (714) 828-1800

Other names 1

  • DiscoveryMD, Hanover Doing business as

National Provider Directory

National Provider Directory
Tax ID family
New Life Addiction Counseling Services Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

18401 Von Karman Ave
Ste 500
Irvine, CA 92612
Phone (305) 343-5995

NPI Registry JSON

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1235566373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18401 VON KARMAN AVE STE 500",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926128531",
            "telephone_number": "714-828-1800",
            "fax_number": "714-882-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7240 PARKWAY DR STE 140",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761367",
            "telephone_number": "714-828-1800",
            "fax_number": "714-882-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE ADDICTION COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-03",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "GUSTILO",
        "authorized_official_first_name": "MAGDALEN",
        "authorized_official_title_or_position": "DIRECTOR OF PAYER RELATIONS",
        "authorized_official_telephone_number": "714-568-7667"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "LC2259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DiscoveryMD, Hanover",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hanover, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.