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General NPI Number Information
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NPI Number | 1023940079
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Entity Type | Organization
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Legal Business Name | NEW LEAF MENTAL HEALTH & WELLNESS, PLLC
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Dates
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Enumeration Date | 06/02/2026
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Last Update Date | 06/02/2026
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Provider Practice Location Address
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Address Line | 417 W CANAL ST
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City | PICAYUNE
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State | MS
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Zip | 39466-3951
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Country | US
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Telephone | 601-916-0665
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Fax |
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Provider Business Mailing Address
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Address Line | 204 SHAWTOWN RD
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City | PERKINSTON
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State | MS
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Zip | 39573-4302
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Country | US
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Telephone | 601-916-0665
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DEVEN FEJKA CAMERON
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Credential | FNP-C, PMHNP-C
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Telephone | 601-916-0665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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