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Search › Indiana › 103TH0100X

Leroy Burgess, PSYCHOLOGIST

NPI 1528449964 · on the registry since 2015 · sole proprietor

Practice

Address
300 S Saint Louis Blvd Ste 202
South Bend, IN 46617
Phone
(574) 232-1405
Fax
(574) 232-0124
Organisation at this address
Rci (Wrs), Llc
New Avenues Inc.
Ketamine Is Hope Llc
Rush-Select Holdings, Llc
Gwendolyn Dehorn Lcsw Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
9

Registry record

Primary taxonomy
103TH0100X
103TH0100X
Licence states on file
IN
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2015-06-11

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana