Provider Demographics
NPI:1174706717
Name:LEER, JODIE ANN (MA LMHC)
Entity type:Individual
Prefix:MRS
First Name:JODIE
Middle Name:ANN
Last Name:LEER
Suffix:
Gender:F
Credentials:MA LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3624 S MADISON ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-2216
Mailing Address - Country:US
Mailing Address - Phone:253-224-6686
Mailing Address - Fax:
Practice Address - Street 1:315 MLK WAY JR
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2858
Practice Address - Country:US
Practice Address - Phone:425-902-7995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WALH60160821101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health