Provider Demographics
NPI:1922856400
Name:NEW LEAF COUNSELING CENTER LLC
Entity type:Organization
Organization Name:NEW LEAF COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRIFKA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:401-487-1600
Mailing Address - Street 1:17 MINGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-5152
Mailing Address - Country:US
Mailing Address - Phone:401-487-1600
Mailing Address - Fax:
Practice Address - Street 1:1130 TEN ROD RD STE F204
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4172
Practice Address - Country:US
Practice Address - Phone:401-487-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty