Provider Demographics
NPI:1255493045
Name:LEIBIG, ANNE BEATRICE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:BEATRICE
Last Name:LEIBIG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1443
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24212-1443
Mailing Address - Country:US
Mailing Address - Phone:276-628-1664
Mailing Address - Fax:276-628-8905
Practice Address - Street 1:350 RUSEEL ROAD
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24212-1443
Practice Address - Country:US
Practice Address - Phone:276-628-1664
Practice Address - Fax:276-628-8905
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA094001054104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker