Provider Demographics
NPI:1780446583
Name:A NEW LEAF COUNSELING LLC
Entity type:Organization
Organization Name:A NEW LEAF COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUGHREY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-614-6776
Mailing Address - Street 1:43 COTTAGE WOODS RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04222-5485
Mailing Address - Country:US
Mailing Address - Phone:207-614-6776
Mailing Address - Fax:
Practice Address - Street 1:10 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-1932
Practice Address - Country:US
Practice Address - Phone:207-614-6776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)