Provider Demographics
NPI:1881261733
Name:FOUR SEASONS COUNSELING, PLLC
Entity type:Organization
Organization Name:FOUR SEASONS COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEITZINGER
Authorized Official - Suffix:II
Authorized Official - Credentials:LMSW
Authorized Official - Phone:208-954-3714
Mailing Address - Street 1:4204 E ESPERANTO ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-5426
Mailing Address - Country:US
Mailing Address - Phone:208-954-3714
Mailing Address - Fax:
Practice Address - Street 1:158 MCCLURE AVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-2025
Practice Address - Country:US
Practice Address - Phone:208-954-3714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty