# A NEW SPIRIT BEHAVIORAL HEALTH SERVICES, LLC

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

## Provider details

- **NPI number:** 1518464379
- **Authorized official:** DR. DENISE RAY-SHIELDS PHD (OWNER/THERAPIST)
- **Authorized official phone:** (610) 772-3939

## Contact information

- **Practice address:** 111 PRESIDENTIAL BLVD LBBY SUITE237, BALA CYNWYD, PA 19004-1008
- **Practice address phone:** (610) 772-3939
- **Practice address fax:** (215) 877-3529
- **Mailing address:** 5745 WOODBINE AVE, PHILADELPHIA, PA 19131-1236
- **Mailing address phone:** (215) 983-1488
- **Mailing address fax:** (215) 877-3529

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | SW005909E | PA | Yes |

## Other

- **Enumeration date:** 04/09/2018
- **Last updated:** 04/09/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000236440 | OPTUM | PA |