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General NPI Number Information
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NPI Number | 1356668156
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Entity Type | Organization
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Legal Business Name | TURN OF A NEWLEAF,INC
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Dates
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Enumeration Date | 05/03/2010
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Last Update Date | 10/07/2011
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Provider Practice Location Address
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Address Line | 9693 HAGEL CIRCLE
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City | LORTON
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State | VA
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Zip | 22079
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Country | US
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Telephone | 703-339-0106
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Fax |
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Provider Business Mailing Address
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Address Line | 9693 HAGEL CIRCLE
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City | LORTON
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State | VA
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Zip | 22079
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Country | US
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Telephone | 703-339-0106
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Fax |
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | MRS. NICOLE SUTHERLAND
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Credential |
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Telephone | 703-339-0106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 1042266
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 1042266
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | 1042266
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 1042266
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1042266
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License Number State | VA
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Taxonomy #6
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 1042266
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License Number State | VA
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Taxonomy #7
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 1042266
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License Number State | VA
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