Provider Demographics
NPI:1124757570
Name:JOLIN, LEIGHA SUZANNE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:LEIGHA
Middle Name:SUZANNE
Last Name:JOLIN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5738 BREEZY PINE RD
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-7504
Mailing Address - Country:US
Mailing Address - Phone:920-588-0488
Mailing Address - Fax:
Practice Address - Street 1:1630 N CHIPPEWA DR
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-9503
Practice Address - Country:US
Practice Address - Phone:715-361-2805
Practice Address - Fax:715-361-2920
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11682-1231041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical