Individual
LEAH DAVIS KEVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1126 S 70TH ST STE 112-3, WEST ALLIS, WI 53214-3124
(414) 727-2789
Mailing address
2416 DEERFIELD CT, SAUKVILLE, WI 53080-2438
(414) 534-2783
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0000769
CO
104100000X
Social Worker
00009920539
CO
1041C0700X
Clinical Social Worker
Primary
8817-123
WI
1041C0700X
Clinical Social Worker
CSW.09924533
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8817-123
WISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES
WI
05
—
8817-123
—
WI
Enumeration date
10/06/2014
Last updated
03/17/2018
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