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General NPI Number Information
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NPI Number | 1336310754
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Entity Type | Organization
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Legal Business Name | NEW LEAF COUNSELING, INC.
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Dates
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Enumeration Date | 03/13/2008
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Last Update Date | 03/13/2008
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Provider Practice Location Address
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Address Line | 1704 1/2 S CONGRESS AVE SUITE P
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City | AUSTIN
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State | TX
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Zip | 78704-3559
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Country | US
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Telephone | 512-466-0835
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Fax | 512-292-9620
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Provider Business Mailing Address
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Address Line | 1704 1/2 S CONGRESS AVE SUITE P
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City | AUSTIN
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State | TX
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Zip | 78704-3559
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Country | US
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Telephone | 512-466-0835
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Fax | 512-292-9620
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Authorized Official
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Title or Position | OWNER
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Name | SETH HOUDESHELL
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Credential | LCSW
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Telephone | 512-466-0835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 33697
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License Number State | TX
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