| Leigh Ellis Counseling Llc | |
|
1525 Tremont Blvd Nw Grand Rapids MI 49504-4864 | |
| (616) 648-0441 | |
| Not Available |
| Full Name | Leigh Ellis Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 1525 Tremont Blvd Nw, Grand Rapids, Michigan |
| Authorized Official Name and Position | Leigh Ellis (OWNER) |
| Authorized Official Contact | 6166480441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leigh Ellis Counseling Llc 1525 Tremont Blvd Nw Grand Rapids MI 49504-4864 Ph: (616) 648-0441 | Leigh Ellis Counseling Llc 1525 Tremont Blvd Nw Grand Rapids MI 49504-4864 Ph: (616) 648-0441 |
| NPI Number | 1568197473 |
|---|---|
| Provider Enumeration Date | 07/24/2022 |
| Last Update Date | 05/18/2023 |
| Certification Date | 05/18/2023 |
| Medicare PECOS PAC ID | 0042738387 |
|---|---|
| Medicare Enrollment ID | O20250520001433 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568197473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Leigh Ellis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457953838 PECOS PAC ID: 5193234177 Enrollment ID: I20250602001356 |
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