Provider Demographics
NPI:1942767124
Name:FOUR LEAF COUNSELING AND CONSULTING
Entity Type:Organization
Organization Name:FOUR LEAF COUNSELING AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TAYLA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:HADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MED CPC CADC
Authorized Official - Phone:702-376-0732
Mailing Address - Street 1:419 SHAMROCK DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-8332
Mailing Address - Country:US
Mailing Address - Phone:702-376-0732
Mailing Address - Fax:
Practice Address - Street 1:311 S WATER ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7524
Practice Address - Country:US
Practice Address - Phone:702-376-0732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty