Provider Demographics
NPI:1912573643
Name:NEW LEAF WELLNESS CENTER
Entity Type:Organization
Organization Name:NEW LEAF WELLNESS CENTER
Other - Org Name:NEW LEAF WELLNESS CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:LEEANN
Authorized Official - Last Name:LADD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:501-593-1250
Mailing Address - Street 1:254 W MULBERRY AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-6709
Mailing Address - Country:US
Mailing Address - Phone:501-593-1250
Mailing Address - Fax:501-285-4410
Practice Address - Street 1:254 W MULBERRY AVE STE 6
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-6709
Practice Address - Country:US
Practice Address - Phone:501-593-1250
Practice Address - Fax:501-825-4410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-02
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty