Provider Demographics
NPI:1063282077
Name:CHALLENGER, LEAH ANNA (LPC)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:ANNA
Last Name:CHALLENGER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 W BITTERSWEET PL APT 705
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2350
Mailing Address - Country:US
Mailing Address - Phone:630-202-3527
Mailing Address - Fax:
Practice Address - Street 1:732 W BITTERSWEET PL APT 705
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2350
Practice Address - Country:US
Practice Address - Phone:630-202-3527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178017348101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional