Provider Demographics
NPI:1023566585
Name:MARAOUI, LEAH SAKODA (LCSW)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:SAKODA
Last Name:MARAOUI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:RACHEL
Other - Last Name:SAKODA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2505 N LAMAR BLVD STE 202B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-4000
Mailing Address - Country:US
Mailing Address - Phone:512-763-2275
Mailing Address - Fax:
Practice Address - Street 1:3906 N LAMAR BLVD STE 202B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-4000
Practice Address - Country:US
Practice Address - Phone:512-763-2275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-13
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094803104100000X
NJ44SC059516001041C0700X
TX1038121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker