NPIMap

Organization Active NPI

New Leaf Therapy LLC

  • Counselor
  • Randolph, MA
National Provider Identifier
1669114153
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
NEW LEAF THERAPY LLC
Practice address
38 Sunset Dr
Randolph, MA 02368-1540
Phone
(781) 739-0872
NPI assigned
Apr 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Authorized official

Name
Gwendolyn Vincent Gerome, LICSW
Title
Owner
Phone
(781) 739-0872

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

38 Sunset Dr
Randolph, MA 02368-1540

Mailing address

38 Sunset Dr
Randolph, MA 02368-1540
Phone (781) 739-0872

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649808000000",
    "number": "1669114153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 SUNSET DR",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023681540",
            "telephone_number": "781-739-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 SUNSET DR",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023681540",
            "telephone_number": "781-739-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LEAF THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-13",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A",
        "authorized_official_last_name": "VINCENT GEROME",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-739-0872",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.