Provider Demographics
NPI:1033720107
Name:CHANCE, LEAH NOEL (LPC)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:NOEL
Last Name:CHANCE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:JACOBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 852
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-0142
Mailing Address - Country:US
Mailing Address - Phone:541-423-2633
Mailing Address - Fax:
Practice Address - Street 1:175 W B ST STE H
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-4575
Practice Address - Country:US
Practice Address - Phone:414-232-6335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC7092101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health