Provider Demographics
NPI:1558896613
Name:WEILAND, LEAH (LCSW)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:WEILAND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 WARRENVILLE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1999
Mailing Address - Country:US
Mailing Address - Phone:331-213-1868
Mailing Address - Fax:331-457-4196
Practice Address - Street 1:339 ALANA DR
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1766
Practice Address - Country:US
Practice Address - Phone:815-462-3827
Practice Address - Fax:815-462-3837
Is Sole Proprietor?:No
Enumeration Date:2017-04-26
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490191521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical