Provider Demographics
NPI:1699390864
Name:LEAF, NORMA (LCPC)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:
Last Name:LEAF
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 1:960 FELL ST UNIT 613
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-3547
Mailing Address - Country:US
Mailing Address - Phone:847-254-5817
Mailing Address - Fax:
Practice Address - Street 1:6600 YORK RD STE 110
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-2023
Practice Address - Country:US
Practice Address - Phone:410-231-3016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC7257101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health