Provider Demographics
NPI:1821520529
Name:BLOCK, LEAH MARIE (MA, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:MARIE
Last Name:BLOCK
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22023 SE WAX RD # 472
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-9998
Mailing Address - Country:US
Mailing Address - Phone:206-424-3696
Mailing Address - Fax:206-536-1110
Practice Address - Street 1:119 PELLY AVE N
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5714
Practice Address - Country:US
Practice Address - Phone:206-424-3696
Practice Address - Fax:206-210-6809
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009191101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health