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General NPI Number Information
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NPI Number | 1215603840
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Entity Type | Individual
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Provider Name | LEANNE BERGEY
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Gender | Female
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Dates
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Enumeration Date | 08/23/2021
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Last Update Date | 05/23/2022
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Provider Practice Location Address
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Address Line | 552 S WASHINGTON ST STE 115
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City | NAPERVILLE
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State | IL
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Zip | 60540-6669
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Country | US
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Telephone | 331-431-4719
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Fax |
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Provider Business Mailing Address
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Address Line | 1315 W GALENA BLVD
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City | AURORA
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State | IL
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Zip | 60506-3648
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Country | US
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Telephone | 209-247-7749
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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