Provider Demographics
NPI:1639130289
Name:ALI, FIROZA LEENA (MA, LMHC, NBCBT)
Entity Type:Individual
Prefix:MRS
First Name:FIROZA
Middle Name:LEENA
Last Name:ALI
Suffix:
Gender:F
Credentials:MA, LMHC, NBCBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 W DEERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-3475
Mailing Address - Country:US
Mailing Address - Phone:765-284-7495
Mailing Address - Fax:765-529-3370
Practice Address - Street 1:321 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:IN
Practice Address - Zip Code:47362-4218
Practice Address - Country:US
Practice Address - Phone:765-529-2213
Practice Address - Fax:765-529-3370
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN260-426-7234101Y00000X
IN39000113A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000182116OtherBLUE CROSS/BLUE SHIELD