Active NPI
Leah M Bruce, LPC, SAC
- Professional Counselor
- Mequon, WI
National Provider Identifier
1063802403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6371-125
- Practice address
- 11124 N Cedarburg Rd Ste 150
Mequon, WI 53092-4362 - Phone
- (616) 318-0066
- NPI assigned
- Jan 23, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401224378 | MI | |
| Professional Counselor | 101YP2500X | 6371-125 | WI | Primary |
Addresses
Primary practice location
11124 N Cedarburg Rd Ste 150
Mequon, WI 53092-4362
Mailing address
11124 N Cedarburg Rd Ste 150
Mequon, WI 53092-4362
Phone (616) 318-0066
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17306-130 | Other | WI | WISCONSIN LICENSE |
| 6371-125 | Other | WI | LICENSED PROFESSIONAL COUNSELOR |
| 6401224378 | Other | MI | LPC |
| 1063802403 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401224378 | MI | MD | Professional Counselor |
| 6371-125 | WI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772668800000",
"number": "1063802403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11124 N CEDARBURG RD STE 150",
"city": "MEQUON",
"state": "WI",
"postal_code": "530924362",
"telephone_number": "616-318-0066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11124 N CEDARBURG RD STE 150",
"city": "MEQUON",
"state": "WI",
"postal_code": "530924362",
"telephone_number": "616-318-0066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUCE",
"first_name": "LEAH",
"middle_name": "M",
"credential": "LPC, SAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-23",
"last_updated": "2026-03-05",
"certification_date": "2026-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401224378",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "6371-125",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WISCONSIN LICENSE",
"identifier": "17306-130",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED PROFESSIONAL COUNSELOR",
"identifier": "6371-125",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC",
"identifier": "6401224378",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1063802403",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mequon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.