=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245192657
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LEAP OF FAITH PSYCHOTHERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/25/2025
-----------------------------------------------------
Last Update Date | 11/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 851 STATE ROUTE 103
-----------------------------------------------------
City | BLUFFTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45817-9620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 567-825-0981
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 851 STATE ROUTE 103
-----------------------------------------------------
City | BLUFFTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45817-9620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 567-825-0981
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | FAITH ABEYTA
-----------------------------------------------------
Credential | LISW
-----------------------------------------------------
Telephone | 567-825-0981
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------