Provider Demographics
NPI:1194404806
Name:NEW LEAF PSYCHOLOGICAL SERVICES, LLC
Entity type:Organization
Organization Name:NEW LEAF PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HITTEL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:813-738-3898
Mailing Address - Street 1:3502 HENDERSON BLVD STE 306
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3970
Mailing Address - Country:US
Mailing Address - Phone:813-738-3898
Mailing Address - Fax:813-642-4893
Practice Address - Street 1:3502 HENDERSON BLVD STE 306
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3970
Practice Address - Country:US
Practice Address - Phone:813-738-3898
Practice Address - Fax:813-642-4893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty