Provider Demographics
NPI:1770396426
Name:FARR-FIELDS, LEAH DELORES (LPC)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:DELORES
Last Name:FARR-FIELDS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7719 163RD PL
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-1436
Mailing Address - Country:US
Mailing Address - Phone:708-717-5671
Mailing Address - Fax:
Practice Address - Street 1:6500 W COLLEGE DR STE 2-2NE
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1773
Practice Address - Country:US
Practice Address - Phone:708-929-8333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.021092101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health