MS. FANNIE M. LEFLORE MS LPCCADC-D NPI 1063464436

NPI Information

NPI: 1063464436
Provider Name: MS. FANNIE M. LEFLORE, MS, LPC,CADC-D
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
6310 N PORT WASHINGTON RD
OFFICE SPACE INSIDE R.E.A.C.H. CLINIC
GLENDALE, WI
ZIP 53217
Phone: (414) 438-1534
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MS. Fannie M. Leflore, MS, LPC,CADC-D is a mental health counselor in Glendale, WI. MS. Fannie M. Leflore, MS, LPC,CADC-D NPI is 1063464436. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6310 N PORT WASHINGTON RD
OFFICE SPACE INSIDE R.E.A.C.H. CLINIC
GLENDALE, WI
ZIP 53217-300
Phone: (414) 438-1534

The enumeration date for this NPI number is 5/16/2006 and was last updated on 9/20/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	13220	WISCONSIN	No
2	101YM0800X	Counselor	Mental Health	2250-125	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2250-125	OTHER	WISCONSIN	LICENSED PROF COUNSELOR
2	13220	OTHER	WISCONSIN	CADC-D
3	40920600	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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