Provider Demographics
NPI:1619795713
Name:NEW LAND THERAPY LLC
Entity type:Organization
Organization Name:NEW LAND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZORYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAKHNOVETS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:843-469-5247
Mailing Address - Street 1:356 TUCKER DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-4944
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:356 TUCKER DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-4944
Practice Address - Country:US
Practice Address - Phone:843-469-5247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-28
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty