Brian Douglas Leidal, MA LPC CMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401223256 Issued in MI

Practice address

405 Little Lake Dr Ste a
Ann Arbor, MI 48103-6220

Phone

(734) 719-0380

NPI assigned

Oct 11, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1154083897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 WOOD ST APT 3",
            "city": "BRISTOL",
            "state": "RI",
            "postal_code": "028093169",
            "telephone_number": "313-969-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 LITTLE LAKE DR STE A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036220",
            "telephone_number": "734-719-0380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 S Huron Pkwy Ste 3D",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481045133",
            "country_code": "US",
            "telephone_number": "734-719-0380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "469 Centerville Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028864356",
            "country_code": "US",
            "telephone_number": "313-969-2288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEIDAL",
        "first_name": "BRIAN",
        "middle_name": "DOUGLAS",
        "credential": "MA LPC CMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-11",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "MHC01319",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "10460707-6004",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0013400",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401223256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Svrcina Lehman
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• Robert Anthony Lehrer, P.A.
• Julie Merz Lehrmann, LMSW
• Alan B Leichtman, MD
• Janet Leigh, MA LLP
• Amy Lynn Leightner, CRNA
• Leimstoll Center
• Dawn Colleen Leimstoll
• Alyssa Marie Leineke

• Mental Health Counselor in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.