Provider Demographics
NPI:1609912765
Name:LEET, BRIAN ROBERT (LPCC)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:ROBERT
Last Name:LEET
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31201 POLK ST NE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008-6829
Mailing Address - Country:US
Mailing Address - Phone:612-240-7497
Mailing Address - Fax:763-689-5291
Practice Address - Street 1:31201 POLK ST NE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008-6829
Practice Address - Country:US
Practice Address - Phone:612-240-7497
Practice Address - Fax:763-689-5291
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00231101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health