Provider Demographics
NPI:1184215063
Name:LEEK THERAPY, LLC
Entity Type:Organization
Organization Name:LEEK THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:ROSETTA
Authorized Official - Last Name:LEEK
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:508-418-8242
Mailing Address - Street 1:PO BOX 793
Mailing Address - Street 2:
Mailing Address - City:HYANNIS PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02647-0793
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:89 LEWIS BAY RD
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5240
Practice Address - Country:US
Practice Address - Phone:508-418-8242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty