New Leaf Adolescent Care, Inc

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

8301256B Issued in NC

Legal business name

NEW LEAF ADOLESCENT CARE, INC

Practice address

1945 J N Pease PL Ste 102
Charlotte, NC 28262-4555

Phone

(704) 405-8890

Fax

(704) 405-8893

NPI assigned

Jan 17, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Mickey Leon Rivers Sr.

Title

Ceo

Phone

(704) 891-5825

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Tax ID family

New Leaf Adolescent Care Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• New Leaf Adolescent Care, Inc

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1881873412
  NPD tax ID

Locations

Practitioners 3

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

• Bree Thompson, LCMHC, LCAS

  • Professional Counselor
  • Charlotte, NC
  • NPI 1306332879
  Medicare reassignment NPD
• Ariana Nicole Mitchem

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1508639196
  NPD
• Tiffany Nicole Huger, MSW, LCSWA

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1780193565

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607040000000",
    "number": "1821140401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 J N PEASE PL STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624555",
            "telephone_number": "704-405-8890",
            "fax_number": "704-405-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 J N PEASE PL STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624555",
            "telephone_number": "704-405-8890",
            "fax_number": "704-405-8893"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6801 Water Mill Ct",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282152520",
            "country_code": "US",
            "telephone_number": "704-910-4029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1931 J N Pease Pl",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282624544",
            "country_code": "US",
            "telephone_number": "704-405-8890",
            "fax_number": "704-405-8893",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Silas Creek Pkwy Ste 4B",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271035000",
            "country_code": "US",
            "telephone_number": "336-778-3804",
            "fax_number": "336-778-3808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEW LEAF ADOLESCENT CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A",
        "authorized_official_last_name": "RIVERS",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-891-5825",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": "8301256B",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-060-802",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-090-146",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301256B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060-802",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• New Horizon Home Care LLP
• New Horizon Residential Services L.L.C
• New Horizons Youth & Family Services, LLC
• New Kydz of Hope LLC
• New Leaf Adolescent Care
• New Leaf Adolescent Care, Inc
• New Level Family Services LLC
• New Life Home Care LLC
• New Life in Home and Therapeutic Care LLC
• New Life Peer Support and Coaching LLC

• Case Management Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Case Management Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.