Provider Demographics
NPI:1427534684
Name:RYBAKOWSKI, LEAH JEAN (LCPC)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:JEAN
Last Name:RYBAKOWSKI
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 1:4237 SYCAMORE BND
Mailing Address - Street 2:
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-9525
Mailing Address - Country:US
Mailing Address - Phone:847-894-7146
Mailing Address - Fax:
Practice Address - Street 1:4237 SYCAMORE BND
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-9525
Practice Address - Country:US
Practice Address - Phone:847-894-7146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-11
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.014020101YM0800X
IL180.014532101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health