Provider Demographics
NPI:1497187298
Name:BRITTNACHER, LEAH MICHELLE (LMHP, PLP)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:MICHELLE
Last Name:BRITTNACHER
Suffix:
Gender:F
Credentials:LMHP, PLP
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:MICHELLE
Other - Last Name:VAN GRINSVEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1881 CHICAGO ST
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-3770
Mailing Address - Country:US
Mailing Address - Phone:920-403-8000
Mailing Address - Fax:920-403-8209
Practice Address - Street 1:1881 CHICAGO ST
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-3770
Practice Address - Country:US
Practice Address - Phone:920-403-8000
Practice Address - Fax:920-403-8209
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10009101Y00000X
WI3288103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47037660624Medicaid
NE47037660631Medicaid
WI100048163Medicaid
NE10026139700Medicaid