Healthcare Provider Details

I. General information

NPI: 1487570149
Provider Name (Legal Business Name): NEW LEAF COUNSELING AND CONSULTING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

284 FOREST PARK CIR
PANAMA CITY FL
32405-4921
US

IV. Provider business mailing address

7901 4TH ST N STE 300
ST PETERSBURG FL
33702-4399
US

V. Phone/Fax

Practice location:
  • Phone: 850-361-8262
  • Fax:
Mailing address:
  • Phone: 850-361-8262
  • 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: RUTHANN MADDOX
Title or Position: COUNSELOR
Credential:
Phone: 850-361-8262