Healthcare Provider Details

I. General information

NPI: 1588322663
Provider Name (Legal Business Name): LEYNA FLECKENSTEIN LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2021
Last Update Date: 12/06/2021
Certification Date: 12/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8623 N WAYNE RD STE 123
WESTLAND MI
48185-1137
US

IV. Provider business mailing address

101 SHEFFIELD
SALINE MI
48176-1020
US

V. Phone/Fax

Practice location:
  • Phone: 734-367-0469
  • Fax:
Mailing address:
  • Phone: 734-864-2512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6851108408
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: