Provider Demographics
NPI:1023535366
Name:LEITHE, ERIK (LCSW)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:LEITHE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7522
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59807-7522
Mailing Address - Country:US
Mailing Address - Phone:406-552-3803
Mailing Address - Fax:406-829-1400
Practice Address - Street 1:210 N HIGGINS AVE STE 338
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4443
Practice Address - Country:US
Practice Address - Phone:406-552-3893
Practice Address - Fax:406-829-1400
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-251171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical