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General NPI Number Information
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NPI Number | 1023943313
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Entity Type | Individual
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Provider Name | PAYTON ISABELLA RENS LEUTNER LPC-IT
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Gender | Female
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Dates
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Enumeration Date | 06/16/2026
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Last Update Date | 06/16/2026
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Provider Practice Location Address
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Address Line | 11803 W NORTH AVE STE 200
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City | WAUWATOSA
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State | WI
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Zip | 53226-2077
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Country | US
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Telephone | 414-999-0102
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Fax |
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Provider Business Mailing Address
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Address Line | 4369 S HOWELL AVE STE 306
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City | MILWAUKEE
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State | WI
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Zip | 53207-5098
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Country | US
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Telephone | 414-999-0102
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 9054-226
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License Number State | WI
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