Provider Demographics
NPI:1427417229
Name:SPRATT, LADELL LEIGH (CPSS/SST)
Entity Type:Individual
Prefix:MR
First Name:LADELL
Middle Name:LEIGH
Last Name:SPRATT
Suffix:
Gender:M
Credentials:CPSS/SST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23205 GRATIOT AVE # 181
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-1641
Mailing Address - Country:US
Mailing Address - Phone:586-252-2061
Mailing Address - Fax:586-252-2061
Practice Address - Street 1:23205 GRATIOT AVE # 181
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-1641
Practice Address - Country:US
Practice Address - Phone:586-252-2061
Practice Address - Fax:586-252-2061
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6803086215101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health