Provider Demographics
NPI:1073107645
Name:MARCUS, LEAH FALEER (LLPC)
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:FALEER
Last Name:MARCUS
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:MS
Other - First Name:LEAH
Other - Middle Name:HOLTON
Other - Last Name:FALEER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2601 JACKSON AVE # 1035
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-3820
Mailing Address - Country:US
Mailing Address - Phone:734-926-8506
Mailing Address - Fax:
Practice Address - Street 1:1368 KING GEORGE BLVD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-3216
Practice Address - Country:US
Practice Address - Phone:734-926-8506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451015823101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional