Provider Demographics
NPI:1194577098
Name:NEW FRONTIERS COUNSELING LLC
Entity type:Organization
Organization Name:NEW FRONTIERS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:C
Authorized Official - Last Name:BANACH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:719-217-4609
Mailing Address - Street 1:105 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-2215
Mailing Address - Country:US
Mailing Address - Phone:719-217-4609
Mailing Address - Fax:719-204-3829
Practice Address - Street 1:105 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN
Practice Address - State:CO
Practice Address - Zip Code:80817-2215
Practice Address - Country:US
Practice Address - Phone:719-217-4609
Practice Address - Fax:719-362-4281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-03
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty