Provider Demographics
NPI:1558437673
Name:LEICHT, CHERYL (LCPC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:LEICHT
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 1:3203 3RD AVE N
Mailing Address - Street 2:SUITE 208
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-1945
Mailing Address - Country:US
Mailing Address - Phone:406-252-4270
Mailing Address - Fax:406-294-0967
Practice Address - Street 1:3203 3RD AVE N
Practice Address - Street 2:SUITE 208
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1945
Practice Address - Country:US
Practice Address - Phone:406-252-4270
Practice Address - Fax:406-294-0967
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT746LCPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0255697Medicaid