Provider Demographics
NPI:1346059003
Name:WEIRES, LEAH MARIE (LPCC)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:MARIE
Last Name:WEIRES
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:BEIGHLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 SILVER LAKE RD NW STE 110
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-1789
Mailing Address - Country:US
Mailing Address - Phone:651-628-9566
Mailing Address - Fax:651-628-0411
Practice Address - Street 1:114 MAIN ST N STE 201B
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-1819
Practice Address - Country:US
Practice Address - Phone:320-753-0778
Practice Address - Fax:320-753-0779
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2566101YP2500X
MN307238101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)