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NPI Code Detail

MEDICARE: LEAH BROYLES LCSW, C-DBT

MEDICARE: LEAH BROYLES LCSW, C-DBT
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
11041C0700XClinical Social Worker6801115233MI

General Provider Information

NPI Number : 1689293979
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH BROYLES LCSW, C-DBT
Provider Business Mailing Address
First Line : 2215 FULLER RD
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105-2303
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2215 FULLER RD
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105-2303
Country : US
Telephone Number : 734-769-7100
Fax Number : 810-225-9579
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2020
Last Update Date : 04/06/2026

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Directions to “ LEAH BROYLES LCSW, C-DBT” Practice Location

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