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General NPI Number Information
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NPI Number | 1063078020
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Entity Type | Organization
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Legal Business Name | LEIA STEIN COUNSELING LLC
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Dates
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Enumeration Date | 05/15/2019
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Last Update Date | 05/15/2019
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Provider Practice Location Address
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Address Line | 785 WALL ST STE 200
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City | O FALLON
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State | IL
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Zip | 62269-1959
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Country | US
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Telephone | 618-670-9069
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Fax |
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Provider Business Mailing Address
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Address Line | 544 STONEFIELD DR
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City | SMITHTON
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State | IL
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Zip | 62285-1560
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Country | US
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Telephone | 618-670-9069
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MRS. LEIA K STEIN
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Credential | MA, LCPC
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Telephone | 618-670-9069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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