Provider Demographics
NPI:1063832707
Name:LEAH MCINTIRE, MA, LPC
Entity Type:Organization
Organization Name:LEAH MCINTIRE, MA, LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCINTIRE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:304-241-4123
Mailing Address - Street 1:5000 GREENBAG RD
Mailing Address - Street 2:SUITE M4
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-7163
Mailing Address - Country:US
Mailing Address - Phone:304-241-4123
Mailing Address - Fax:304-381-4447
Practice Address - Street 1:5000 GREENBAG RD
Practice Address - Street 2:SUITE M4
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-7163
Practice Address - Country:US
Practice Address - Phone:304-241-4123
Practice Address - Fax:304-381-4447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2014251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1588090385OtherNPI