Provider Demographics
NPI:1972189769
Name:NEW LEAF HEALING LLC
Entity Type:Organization
Organization Name:NEW LEAF HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:SHAUNNA
Authorized Official - Middle Name:CHRISTIE
Authorized Official - Last Name:OSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:970-460-6356
Mailing Address - Street 1:2401 CREEKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2033
Mailing Address - Country:US
Mailing Address - Phone:970-310-7799
Mailing Address - Fax:
Practice Address - Street 1:2401 CREEKWOOD DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2033
Practice Address - Country:US
Practice Address - Phone:970-310-7799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty