Mary Jo Leimbach, MA, LPC

Individual provider Active NPI Professional Counselor · Milan, TN

NPI 1235634445 · NPPES record last updated Mar 28, 2018

Key facts

NPI
1235634445
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
178.013811 (IL)
Practice address
42 Seavers Rd
Milan, TN 38358-6176
Phone
(217) 917-5764
NPI assigned
Mar 28, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
178.013811ILMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.013811 IL Yes

Addresses

Primary practice location

42 Seavers Rd
Milan, TN 38358-6176

Mailing address

42 Seavers Rd
Milan, TN 38358-6176
Phone (217) 917-5764

Other providers in Milan, TN

All providers in Milan, TN · Professional Counselor in Tennessee

Sources for this page

Verify at the official NPI Registry.