Provider Demographics
NPI:1245611102
Name:THOMAS, LEANNE (MS PSYCHOLOGY)
Entity Type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 REBER ST
Mailing Address - Street 2:
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-9060
Mailing Address - Country:US
Mailing Address - Phone:610-462-1625
Mailing Address - Fax:
Practice Address - Street 1:464 REBER ST
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-9060
Practice Address - Country:US
Practice Address - Phone:610-462-1625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002732101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health