| New Leaf Counseling Services Llc | |
|
215 Miller Rd Ste 7 Avon Lake OH 44012-1013 | |
| (440) 742-1661 | |
| (440) 653-9576 |
| Full Name | New Leaf Counseling Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 215 Miller Rd Ste 7, Avon Lake, Ohio |
| Authorized Official Name and Position | Katherine Koncilja (PRESIDENT) |
| Authorized Official Contact | 2163389088 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Leaf Counseling Services Llc 215 Miller Rd Ste 7 Avon Lake OH 44012-1013 Ph: (440) 742-1661 | New Leaf Counseling Services Llc 215 Miller Rd Ste 7 Avon Lake OH 44012-1013 Ph: (440) 742-1661 |
| NPI Number | 1609197631 |
|---|---|
| Provider Enumeration Date | 06/14/2010 |
| Last Update Date | 08/26/2020 |
| Certification Date | 08/26/2020 |
| Medicare PECOS PAC ID | 4486812997 |
|---|---|
| Medicare Enrollment ID | O20120229000579 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609197631 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 090037 (Ohio) | Secondary |
| 101YP2500X | Counselor - Professional | E1000011 (Ohio) | Primary |
| Provider Name | Lee A Strouse |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1538473780 PECOS PAC ID: 9234355108 Enrollment ID: I20140730000165 |
| Provider Name | Sara R Massey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821427899 PECOS PAC ID: 8022352194 Enrollment ID: I20181129002498 |
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