Provider Demographics
NPI:1053097204
Name:JAMIE LEECH COUNSELING, LLC
Entity type:Organization
Organization Name:JAMIE LEECH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEECH
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:815-499-4890
Mailing Address - Street 1:PO BOX 274
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61051-0274
Mailing Address - Country:US
Mailing Address - Phone:815-499-4890
Mailing Address - Fax:
Practice Address - Street 1:414 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:IL
Practice Address - Zip Code:61051-9506
Practice Address - Country:US
Practice Address - Phone:815-499-4890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty