# NEW CREATION COUNSELING AND THERAPEUTIC BODYWORK INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1558125468
- **Authorized official:** PAMELA DIANE TRICE PSYD (PRESIDENT)
- **Authorized official phone:** (630) 207-5537

## Contact information

- **Practice address:** 5878 MIZPAH CT, LAKELAND, FL 33810-1841
- **Practice address phone:** (630) 207-5537
- **Practice address fax:** (888) 873-1159
- **Mailing address:** 5878 MIZPAH CT, LAKELAND, FL 33810-1841
- **Mailing address phone:** (630) 207-5537
- **Mailing address fax:** (888) 873-1159

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 02/12/2024
- **Last updated:** 02/13/2024