Healthcare Provider Details

I. General information

NPI: 1952233033
Provider Name (Legal Business Name): ALEAH ENYEART LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 GLENLAKE DR
SOUTH BEND IN
46614-2838
US

IV. Provider business mailing address

1445 GLENLAKE DR
SOUTH BEND IN
46614-2838
US

V. Phone/Fax

Practice location:
  • Phone: 574-208-8236
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34012901A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number34012901A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: