Organization
TURN OF A NEWLEAF,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE SUTHERLAND (CEO/FOUNDER)
(703) 339-0106
Entity
Organization
Contact information
Practice address
9693 HAGEL CIRCLE, LORTON, VA 22079
(703) 339-0106
Mailing address
9693 HAGEL CIRCLE, LORTON, VA 22079
(703) 339-0106
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
1042266
VA
103TC2200X
Clinical Child & Adolescent Psychologist
1042266
VA
103TF0000X
Family Psychologist
1042266
VA
251B00000X
Case Management Agency
1042266
VA
251S00000X
Community/Behavioral Health Agency
1042266
VA
302F00000X
Exclusive Provider Organization
1042266
VA
305R00000X
Preferred Provider Organization
Primary
1042266
VA
Other
Enumeration date
05/03/2010
Last updated
10/07/2011
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