Provider Demographics
NPI:1245245943
Name:LEIGH BEARES, KRISTIN HELENE (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:HELENE
Last Name:LEIGH BEARES
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MS
Other - First Name:KRISTIN
Other - Middle Name:HELENE
Other - Last Name:LEIGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:CMR 442 ATTN: CREDENTIALS OFFICE
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09042
Mailing Address - Country:DE
Mailing Address - Phone:49622-117-2274
Mailing Address - Fax:49622-117-2941
Practice Address - Street 1:HANAU HEALTH CLINIC
Practice Address - Street 2:CMR 470
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09165
Practice Address - Country:DE
Practice Address - Phone:4906181-500-6732
Practice Address - Fax:4906181-500-6668
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD116371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical