Provider Demographics
NPI:1073895348
Name:WEBER, LEAH JEAN (LMHC)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:JEAN
Last Name:WEBER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 N GEORGIA AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-3435
Mailing Address - Country:US
Mailing Address - Phone:641-422-0070
Mailing Address - Fax:641-422-0060
Practice Address - Street 1:22 N GEORGIA AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-3435
Practice Address - Country:US
Practice Address - Phone:641-422-0070
Practice Address - Fax:641-422-0060
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001418101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health