MEDICARE: LEAH M BRUCE LPC, SAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	6401224378	MI
2	101YP2500X	Professional Counselor	6371-125	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	17306-130	OTHER	WI	WISCONSIN LICENSE
2	6371-125	OTHER	WI	LICENSED PROFESSIONAL COUNSELOR
3	6401224378	OTHER	MI	LPC
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063802403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEAH M BRUCE LPC, SAC

Provider Business Mailing Address
First Line	:	11124 N CEDARBURG RD STE 150
Second Line	:
City	:	MEQUON
State	:	WI
Zip	:	53092-4362
Country	:	US
Telephone Number	:	616-318-0066
Fax Number	:

Provider Business Practice Location Address
First Line	:	11124 N CEDARBURG RD STE 150
Second Line	:
City	:	MEQUON
State	:	WI
Zip	:	53092-4362
Country	:	US
Telephone Number	:	616-318-0066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2015
Last Update Date	:	03/05/2026

Similar Medicare Providers

1487701645 — SOLUTIONS BEHAVIORAL HEALTH GROUP, SC
Practice Location Address:

11124 N CEDARBURG RD STE 150
MEQUON, WI
53092-4362

Practice Phone: 262-478-0032
Practice Fax: 262-478-0082

1376437962 — CAMERON CHET CORLESS
Practice Location Address:

11124 N CEDARBURG RD STE 150
MEQUON, WI
53092-4362

Practice Phone: 262-365-9825
Practice Fax:

1538179783 — SHIRISH P PATEL MD
Practice Location Address:

10945 N PORT WASHINGTON RD STE 201
MEQUON, WI
53092-5078

Practice Phone: 262-292-3151
Practice Fax:

1922561778 — NEW CENTURY HOME CARE LLC
Practice Location Address:

11514 N PORT WASHINGTON RD STE 110
MEQUON, WI
53092-3457

Practice Phone: 262-478-0732
Practice Fax: 262-478-0734

1699639385 — CHIZOBA ADAMMA EZENYI
Practice Location Address:

3915 W MARIANA CT
MEQUON, WI
53092-5190

Practice Phone: 240-606-9376
Practice Fax:

1003810458 — MRS. MARTHA F JAY M.D.
Practice Location Address:

11307 N PORT WASHINGTON RD
MEQUON, WI
53092-3411

Practice Phone: 262-241-1919
Practice Fax: 262-241-9046

Directions to “ LEAH M BRUCE LPC, SAC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.