Provider Demographics
NPI:1083936066
Name:JEFFCOAT, LEONARD G (LCDC)
Entity Type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:G
Last Name:JEFFCOAT
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6730 INDEPENDENCE BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-0204
Mailing Address - Country:US
Mailing Address - Phone:281-421-1524
Mailing Address - Fax:281-421-3484
Practice Address - Street 1:6730 INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-0204
Practice Address - Country:US
Practice Address - Phone:281-421-1524
Practice Address - Fax:281-421-3484
Is Sole Proprietor?:No
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5545101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)