Provider Demographics
NPI:1851752596
Name:CRAFT, LEONA M (MA,LLPC)
Entity Type:Individual
Prefix:MS
First Name:LEONA
Middle Name:M
Last Name:CRAFT
Suffix:
Gender:F
Credentials:MA,LLPC
Other - Prefix:MS
Other - First Name:LEONA
Other - Middle Name:
Other - Last Name:CRAFT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, ED
Mailing Address - Street 1:42155 PELLSTON DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-2413
Mailing Address - Country:US
Mailing Address - Phone:248-380-7456
Mailing Address - Fax:
Practice Address - Street 1:42155 PELLSTON DR
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-2413
Practice Address - Country:US
Practice Address - Phone:248-380-7456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009589101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor