Provider Demographics
NPI:1235641119
Name:LEIBRANDT, ERICA (LCPC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:LEIBRANDT
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1247 WAUKEGAN RD STE 103
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-3057
Mailing Address - Country:US
Mailing Address - Phone:847-657-9890
Mailing Address - Fax:847-657-9891
Practice Address - Street 1:1247 WAUKEGAN RD STE 103
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-3057
Practice Address - Country:US
Practice Address - Phone:847-657-9890
Practice Address - Fax:847-657-9891
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178013437101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health