Provider Demographics
NPI:1326614124
Name:NEW LEAF COUNSELING CENTER
Entity Type:Organization
Organization Name:NEW LEAF COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ASHA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:BISSOONDIAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-636-9305
Mailing Address - Street 1:8780 97TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-2254
Mailing Address - Country:US
Mailing Address - Phone:347-636-9305
Mailing Address - Fax:
Practice Address - Street 1:8780 97TH ST
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-2254
Practice Address - Country:US
Practice Address - Phone:347-636-9305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-02
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty