Healthcare Provider Details

I. General information

NPI: 1184552655
Provider Name (Legal Business Name): NEW LEAF COUNSELING & DEVELOPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4137 CARMICHAEL RD STE 200-16
MONTGOMERY AL
36106-3614
US

IV. Provider business mailing address

160 STONE PARK BLVD APT 607
PIKE ROAD AL
36064-2986
US

V. Phone/Fax

Practice location:
  • Phone: 334-233-3396
  • Fax:
Mailing address:
  • Phone: 334-233-3396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ELIJAH DANIEL
Title or Position: LPC
Credential: LPC
Phone: 334-233-3396