Leib, Jere W
Leib, Jere W is an individual health care provider with primary practice located at 3421 E State Blvd , Fort Wayne IN 46805-4830. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Leib, Jere W can be contacted via phone (260) 482-8427.Contact Information
Primary practice address
3421 E State Blvd
Fort Wayne IN 46805-4830
Phone: (260) 482-8427
Fax: (260) 482-8429
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 20010181 | Indiana |
Profile Details
| NPI number | 1457350506 |
|---|---|
| LBN Legal business name | Leib, Jere W |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2005 |
| Last updated | Aug 12th, 2008 - about 17 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 | 1457350506 | NPPES |
| Indiana | MEDICAID | 100053650 |
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