| New Leaf Mental Health Therapy Llc. | |
|
12951 University Ave Ste 200c Clive IA 50325-8297 | |
| (515) 832-0528 | |
| Not Available |
| Full Name | New Leaf Mental Health Therapy Llc. |
|---|---|
| Speciality | Social Worker |
| Location | 12951 University Ave Ste 200c, Clive, Iowa |
| Authorized Official Name and Position | Laura Ann Nydam (OWNER) |
| Authorized Official Contact | 5158320528 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Leaf Mental Health Therapy Llc. 2755 Nw 165th St Clive IA 50325-2514 Ph: (515) 238-0528 | New Leaf Mental Health Therapy Llc. 12951 University Ave Ste 200c Clive IA 50325-8297 Ph: (515) 832-0528 |
| NPI Number | 1205492089 |
|---|---|
| Provider Enumeration Date | 05/16/2019 |
| Last Update Date | 04/07/2026 |
| Certification Date | 04/07/2026 |
| Medicare PECOS PAC ID | 2466781968 |
|---|---|
| Medicare Enrollment ID | O20190909002929 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205492089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Laura A Nydam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851732481 PECOS PAC ID: 0345540050 Enrollment ID: I20151202002483 |
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