Provider Demographics
NPI:1962228890
Name:LEINWEBER, EMILLEE (CIT)
Entity type:Individual
Prefix:
First Name:EMILLEE
Middle Name:
Last Name:LEINWEBER
Suffix:
Gender:F
Credentials:CIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9477 LANSDOWNE RD TRLR 59
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70818-4638
Mailing Address - Country:US
Mailing Address - Phone:225-577-2423
Mailing Address - Fax:
Practice Address - Street 1:216 S FOSTER DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-4103
Practice Address - Country:US
Practice Address - Phone:225-925-5365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACIT-5727101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)