Provider Demographics
NPI:1033675178
Name:KILPATRICK, LEON CLANCY (LPC-S)
Entity Type:Individual
Prefix:DR
First Name:LEON
Middle Name:CLANCY
Last Name:KILPATRICK
Suffix:
Gender:M
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11013 FREEMONT TRL
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-6717
Mailing Address - Country:US
Mailing Address - Phone:469-766-9479
Mailing Address - Fax:
Practice Address - Street 1:11013 FREEMONT TRL
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-6717
Practice Address - Country:US
Practice Address - Phone:469-766-9479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6481101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional