Provider Demographics
NPI:1013623206
Name:FISHBEIN, LEAH WATSON (LMFT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:WATSON
Last Name:FISHBEIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 SAUNDERS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:RIVERWOODS
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3897
Mailing Address - Country:US
Mailing Address - Phone:301-437-6353
Mailing Address - Fax:
Practice Address - Street 1:302 SAUNDERS RD STE 200
Practice Address - Street 2:
Practice Address - City:RIVERWOODS
Practice Address - State:IL
Practice Address - Zip Code:60015-3897
Practice Address - Country:US
Practice Address - Phone:906-474-5143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166001617106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist