NPIMap

Organization Active NPI

New Leaf Counseling Services, LLC

  • Community/Behavioral Health Agency
  • Glen Carbon, IL
National Provider Identifier
1104101732
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
NEW LEAF COUNSELING SERVICES, LLC
Practice address
9 Junction Dr W Ste 2
Glen Carbon, IL 62034-2931
Phone
(618) 980-2358
Fax
(618) 205-3561
NPI assigned
Oct 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Jean McGurk O'Brien, M.A., LPC, NCCNPI 1093993925
Title
Owner
Phone
(618) 980-2358

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

9 Junction Dr W Ste 2
Glen Carbon, IL 62034-2931

Mailing address

9 Junction Dr W Ste 2
Glen Carbon, IL 62034-2931
Phone (618) 980-2358

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240403002892 IL Part B Supplier - Clinic/Group Practice 5193163632 Receives reassigned benefits from 1 practitioner
Practice locations: Maryville, IL

National Provider Directory

National Provider Directory

Locations

3 Oak Dr
#B
Maryville, IL 62062
Phone (618) 972-1568

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1104101732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 JUNCTION DR W STE 2",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620342931",
            "telephone_number": "618-980-2358",
            "fax_number": "618-205-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 JUNCTION DR W STE 2",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620342931",
            "telephone_number": "618-980-2358",
            "fax_number": "618-205-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LEAF COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-14",
        "last_updated": "2011-10-20",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "MCGURK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-980-2358",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.A., LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Carbon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.