MEDICARE: LEAH ROLLINS

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	101YM0800X	Mental Health Counselor	IMH23626	FL

General Provider Information

NPI Number	:	1982305504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEAH ROLLINS

Provider Business Mailing Address
First Line	:	1033 GRANDVIEW CIR
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-4004
Country	:	US
Telephone Number	:	561-713-9612
Fax Number	:

Provider Business Practice Location Address
First Line	:	721 US 1 STE 112
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-4519
Country	:	US
Telephone Number	:	561-713-9612
Fax Number	:

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

Provider Enumeration Date	:	03/10/2023
Last Update Date	:	03/10/2023

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Directions to “ LEAH ROLLINS ” Practice Location

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