Provider Demographics
NPI:1134730294
Name:RUSIN, LEANNE (LCAC, LMHCA)
Entity type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:RUSIN
Suffix:
Gender:F
Credentials:LCAC, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4194 KATTMAN CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46074-1107
Mailing Address - Country:US
Mailing Address - Phone:317-371-8096
Mailing Address - Fax:
Practice Address - Street 1:8401 HARCOURT RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2036
Practice Address - Country:US
Practice Address - Phone:317-338-4850
Practice Address - Fax:317-338-4890
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87001463A101YA0400X
IN88001567A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health