Provider Demographics
NPI:1487308730
Name:A NEW LEAF CONSULTING & COUNSELING
Entity type:Organization
Organization Name:A NEW LEAF CONSULTING & COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NICHELL
Authorized Official - Middle Name:FOWLER
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, EDD
Authorized Official - Phone:980-477-0334
Mailing Address - Street 1:15105D JOHN J DELANEY DR # 247
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2741
Mailing Address - Country:US
Mailing Address - Phone:980-477-0334
Mailing Address - Fax:
Practice Address - Street 1:1675 CALLAHAN RD
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-7608
Practice Address - Country:US
Practice Address - Phone:864-266-4280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty