Provider Demographics
NPI:1699922609
Name:ZEITZ, LEAH (LPC)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:ZEITZ
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 1:5706 MONMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:VENTNOR CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08406-1844
Mailing Address - Country:US
Mailing Address - Phone:609-334-8566
Mailing Address - Fax:
Practice Address - Street 1:5918 MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-1721
Practice Address - Country:US
Practice Address - Phone:609-334-8566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00373600101YM0800X
NJ37PC0037600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ37PC00373600OtherSTATE OF NEW JERSEY