Provider Demographics
NPI:1801030838
Name:HOEKSTRA, LEAH N (MSW)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:N
Last Name:HOEKSTRA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 E CROSSTOWN PKWY
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-2501
Mailing Address - Country:US
Mailing Address - Phone:269-373-6000
Mailing Address - Fax:269-373-4951
Practice Address - Street 1:615 E CROSSTOWN PKWY
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-2501
Practice Address - Country:US
Practice Address - Phone:269-373-6000
Practice Address - Fax:269-373-4951
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801089385104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker