# FRESH START COUNSELING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114253218
- **Authorized official:** MRS. VEROINCA RAMOS-CLARK MAC (DIRECTOR)
- **Authorized official phone:** (219) 548-9400

## Contact information

- **Practice address:** 1552 W LINCOLNWAY, VALPARAISO, IN 46385-0300
- **Practice address phone:** (219) 548-9400
- **Practice address fax:** (219) 548-9444
- **Mailing address:** 1552 W LINCOLNWAY, VALPARAISO, IN 46385-0300
- **Mailing address phone:** (219) 548-9400
- **Mailing address fax:** (219) 548-9444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 1194-0-ASO | IN | Yes |
| 101YM0800X | Mental Health Counselor | 1194-0-ASO | IN | — |

## Other

- **Enumeration date:** 10/23/2009
- **Last updated:** 10/23/2009