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General NPI Number Information
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NPI Number | 1912573643
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Entity Type | Organization
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Legal Business Name | NEW LEAF WELLNESS CENTER
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Dates
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Enumeration Date | 06/02/2021
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Last Update Date | 01/24/2022
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Provider Practice Location Address
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Address Line | 254 W MULBERRY AVE STE 6
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City | SEARCY
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State | AR
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Zip | 72143-6709
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Country | US
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Telephone | 501-593-1250
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Fax | 501-825-4410
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Provider Business Mailing Address
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Address Line | 254 W MULBERRY AVE STE 6
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City | SEARCY
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State | AR
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Zip | 72143-6709
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Country | US
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Telephone | 501-593-1250
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Fax | 501-285-4410
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MRS. LAURA LEEANN LADD
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Credential | LPC
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Telephone | 501-593-1250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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