Healthcare Provider Details

I. General information

NPI: 1386575074
Provider Name (Legal Business Name): NEW LEAF 25 COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4321 W COLLEGE AVE STE 200
APPLETON WI
54914-3968
US

IV. Provider business mailing address

1155 ESTHER ANN LN
HORTONVILLE WI
54944-2402
US

V. Phone/Fax

Practice location:
  • Phone: 715-281-2610
  • Fax:
Mailing address:
  • Phone: 715-281-2610
  • 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: SANDRA MITTELSTEADT
Title or Position: OWNER
Credential: LPC
Phone: 715-281-2610