New Foundations for Healthy Living,LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

NEW FOUNDATIONS FOR HEALTHY LIVING,LLC

Practice address

1411 Mutz Dr
Indianapolis, IN 46229-2250

Phone

(317) 252-3990

NPI assigned

May 9, 2011

Last updated

May 9, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Serquitto Nycole Cornner, MS

Title

President/Ceo

Phone

(317) 252-3990

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304899200000",
    "number": "1538451695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 MUTZ DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 MUTZ DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292250",
            "telephone_number": "317-252-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW FOUNDATIONS FOR HEALTHY LIVING,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-09",
        "last_updated": "2011-05-09",
        "status": "A",
        "authorized_official_last_name": "CORNNER",
        "authorized_official_first_name": "SERQUITTO",
        "authorized_official_middle_name": "NYCOLE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "317-252-3990",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; 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.