Provider Demographics
NPI:1104564426
Name:NEW DAWN THERAPY AND CONSULTING
Entity type:Organization
Organization Name:NEW DAWN THERAPY AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HAMMACK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-283-6577
Mailing Address - Street 1:760 E WARM SPRINGS AVE STE D
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-6459
Mailing Address - Country:US
Mailing Address - Phone:208-793-5631
Mailing Address - Fax:208-225-4995
Practice Address - Street 1:760 E WARM SPRINGS AVE STE D
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712-6459
Practice Address - Country:US
Practice Address - Phone:208-793-5631
Practice Address - Fax:208-225-4995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-25
Last Update Date:2022-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)