Provider Demographics
NPI:1972878387
Name:LEEVER MENTAL HEALTH COUNSELING
Entity type:Organization
Organization Name:LEEVER MENTAL HEALTH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:LEEVER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:772-233-9982
Mailing Address - Street 1:607 SW SAINT LUCIE CRES
Mailing Address - Street 2:SUITE 106
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2851
Mailing Address - Country:US
Mailing Address - Phone:772-233-9982
Mailing Address - Fax:772-872-6176
Practice Address - Street 1:607 SW SAINT LUCIE CRES
Practice Address - Street 2:SUITE 106
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2851
Practice Address - Country:US
Practice Address - Phone:772-233-9982
Practice Address - Fax:772-872-6176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty