Leflore, Fannie M.
Leflore, Fannie M. is an sole proprietor health care provider with primary practice located at 6310 N Port Washington Rd Office Space Inside R.E.A.C.H. Clinic, Glendale WI 53217-4300. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Leflore, Fannie M. can be contacted via phone (414) 438-1534.Contact Information
Primary practice address
6310 N Port Washington Rd Office Space Inside R.E.A.C.H. Clinic
Glendale WI 53217-4300
Phone: (414) 438-1534
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 13220 | Wisconsin |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 2250-125 | Wisconsin |
Profile Details
| NPI number | 1063464436 |
|---|---|
| LBN Legal business name | Leflore, Fannie M. |
| Credentials | MS, LPC,CADC-D |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 16th, 2006 |
| Last updated | Sep 20th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063464436 | NPPES |
| Wisconsin | Other | 2250-125 | LICENSED PROF COUNSELOR |
| Wisconsin | MEDICAID | 40920600 | LICENSED PROF COUNSELOR |
| Wisconsin | Other | 13220 | LICENSED PROF COUNSELOR |
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