Provider Demographics
NPI:1003070913
Name:LEONI, STEPHANIE (LPC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:LEONI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4575 WEBB BRIDGE RD UNIT 4301
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30023-0492
Mailing Address - Country:US
Mailing Address - Phone:678-313-6721
Mailing Address - Fax:678-281-7767
Practice Address - Street 1:4575 WEBB BRIDGE ROAD
Practice Address - Street 2:#4301
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30023
Practice Address - Country:US
Practice Address - Phone:678-313-6721
Practice Address - Fax:678-281-7767
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005043101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GALPC005043OtherLICENSE #