Healthcare Provider Details

I. General information

NPI: 1639130289
Provider Name (Legal Business Name): FIROZA LEENA ALI MA, LMHC, NBCBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 S MAIN ST
NEW CASTLE IN
47362-4218
US

IV. Provider business mailing address

5200 W DEERBROOK DR
MUNCIE IN
47304-3475
US

V. Phone/Fax

Practice location:
  • Phone: 765-529-2213
  • Fax: 765-529-3370
Mailing address:
  • Phone: 765-284-7495
  • Fax: 765-529-3370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number260-426-7234
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39000113A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: