Provider Demographics
NPI:1689262859
Name:NEW SPRUCE, LLC
Entity Type:Organization
Organization Name:NEW SPRUCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WEIDEL
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:305-790-1939
Mailing Address - Street 1:1150 STATE ROUTE 23
Mailing Address - Street 2:
Mailing Address - City:CATSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12414-5030
Mailing Address - Country:US
Mailing Address - Phone:518-947-9140
Mailing Address - Fax:844-867-9062
Practice Address - Street 1:1150 STATE ROUTE 23
Practice Address - Street 2:
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414-5030
Practice Address - Country:US
Practice Address - Phone:518-947-9140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty