Provider Demographics
NPI:1871733014
Name:NEW DAY COUNSELING PA
Entity type:Organization
Organization Name:NEW DAY COUNSELING PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MCDONOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:904-240-5455
Mailing Address - Street 1:808 3RD ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEPTUNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32266-5081
Mailing Address - Country:US
Mailing Address - Phone:904-240-5455
Mailing Address - Fax:904-638-3051
Practice Address - Street 1:808 3RD ST
Practice Address - Street 2:SUITE A
Practice Address - City:NEPTUNE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32266-5081
Practice Address - Country:US
Practice Address - Phone:904-240-5455
Practice Address - Fax:904-638-3051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-28
Last Update Date:2009-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 7446251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11926081OtherCAQH