MEDICARE: NEW LEAF COUNSELING AND CONSULTING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	CP0077	NV

General Provider Information

NPI Number	:	1659795821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW LEAF COUNSELING AND CONSULTING

Provider Business Mailing Address
First Line	:	9444 SUMMER RAIN DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-0105
Country	:	US
Telephone Number	:	702-706-7086
Fax Number	:

Provider Business Practice Location Address
First Line	:	9444 SUMMER RAIN DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-0105
Country	:	US
Telephone Number	:	702-706-7086
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. BRANDON LANE
Credential	:	LCPC
Telephone Number	:	702-706-8096

Provider Enumeration Date	:	02/09/2014
Last Update Date	:	02/10/2014

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Directions to “NEW LEAF COUNSELING AND CONSULTING ” Practice Location

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