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General NPI Number Information
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NPI Number | 1427417229
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Entity Type | Individual
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Provider Name | LADELL LEIGH SPRATT C.P.S.S/S.S.T
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Gender | Male
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Dates
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Enumeration Date | 02/22/2016
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 23205 GRATIOT AVE # 181
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City | EASTPOINTE
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State | MI
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Zip | 48021-1641
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Country | US
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Telephone | 586-252-2061
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Fax | 586-252-2061
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Provider Business Mailing Address
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Address Line | 23205 GRATIOT AVE # 181
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City | EASTPOINTE
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State | MI
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Zip | 48021-1641
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Country | US
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Telephone | 586-252-2061
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Fax | 586-252-2061
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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 | 6803086215
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | MI
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