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General NPI Number Information
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NPI Number | 1386217313
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Entity Type | Individual
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Provider Name | LEAH JEAN RUTKOWSKI MA, LPC, MBC-HWC
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Gender | Female
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Dates
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Enumeration Date | 07/19/2021
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Last Update Date | 06/30/2024
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Provider Practice Location Address
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Address Line | 1205 S MISSION ST STE 14
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City | MOUNT PLEASANT
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State | MI
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Zip | 48858-3939
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Country | US
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Telephone | 989-317-8668
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Fax | 989-355-0734
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Provider Business Mailing Address
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Address Line | 429 N MCEWAN ST
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City | CLARE
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State | MI
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Zip | 48617-1402
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Country | US
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Telephone | 989-317-8668
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Fax | 989-355-0734
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401014255
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License Number State | MI
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