Provider Demographics
NPI:1437709698
Name:BEACH, LEEANN (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:LEEANN
Middle Name:
Last Name:BEACH
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 BIRCHCREST DR
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-1801
Mailing Address - Country:US
Mailing Address - Phone:734-377-8400
Mailing Address - Fax:
Practice Address - Street 1:5565 AIRPORT HWY STE 100
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-7391
Practice Address - Country:US
Practice Address - Phone:419-720-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1902264101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor