Healthcare Provider Details

I. General information

NPI: 1386598886
Provider Name (Legal Business Name): LEAP WELLNESS AND THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 E MAIN ST
DEWITT MI
48820-9410
US

IV. Provider business mailing address

415 E MAIN ST
DEWITT MI
48820-9410
US

V. Phone/Fax

Practice location:
  • Phone: 517-425-2469
  • Fax:
Mailing address:
  • Phone: 517-425-2469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ABIGAIL NASH
Title or Position: LPC
Credential: LPC
Phone: 517-425-2469