Provider Demographics
NPI:1548901879
Name:REACH YOUR HEART OUT PLLC
Entity type:Organization
Organization Name:REACH YOUR HEART OUT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:FALEER
Authorized Official - Last Name:MARCUS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LLPC
Authorized Official - Phone:734-926-8506
Mailing Address - Street 1:2601 JACKSON AVE # 1035
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-3820
Mailing Address - Country:US
Mailing Address - Phone:734-926-8506
Mailing Address - Fax:
Practice Address - Street 1:1368 KING GEORGE BLVD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-3216
Practice Address - Country:US
Practice Address - Phone:440-574-9187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)