| New Leaf Therapy Center, Llc | |
|
1204 Se Louis Dr Mulvane KS 67110-1113 | |
| (316) 351-8696 | |
| (844) 581-0869 |
| Full Name | New Leaf Therapy Center, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1204 Se Louis Dr, Mulvane, Kansas |
| Authorized Official Name and Position | Susan Dutcher (OWNER) |
| Authorized Official Contact | 3163518696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Leaf Therapy Center, Llc 1204 Se Louis Dr Mulvane KS 67110-1113 Ph: (316) 351-8696 | New Leaf Therapy Center, Llc 1204 Se Louis Dr Mulvane KS 67110-1113 Ph: (316) 351-8696 |
| NPI Number | 1417332230 |
|---|---|
| Provider Enumeration Date | 07/22/2015 |
| Last Update Date | 07/22/2015 |
| Medicare PECOS PAC ID | 5890055461 |
|---|---|
| Medicare Enrollment ID | O20180131001039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417332230 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1982 (Kansas) | Primary |
| 106H00000X | Marriage & Family Therapist | 812 (Kansas) | Secondary |
| Provider Name | Susan E Dutcher |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861683294 PECOS PAC ID: 8729121157 Enrollment ID: I20100206000116 |
Compassion Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1204 Se Louis Dr, Mulvane, KS 67110 Phone: 316-409-7857 |