Conzuelo Leiva, LAC
Counselor, Professional in Guttenberg, NJ. Individual provider (NPI-1).
NPI number1164058442
StatusActive
Last updated in NPPESOct 6, 2026
Details
- NPI
- 1164058442
- Entity type
- Individual (NPI-1)
- Name
- Conzuelo Leiva
- Credential
- LAC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 18, 2020
- Certification date
- Oct 6, 2026
- Last updated
- Oct 6, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 37PC00872600 | NJ | Yes |
| 101YM0800X | Counselor, Mental Health | 37AC00350200 | NJ |
Practice location
127 69th StGuttenberg, NJ 07093-3339
Phone 551-274-3876
Mailing address
127 69th StGuttenberg, NJ 07093-3339
Phone 551-274-3876
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