Provider Demographics
NPI:1275884975
Name:WHITE, LEIGH-ANNE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LEIGH-ANNE
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 DURDEN ST
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30474-4600
Mailing Address - Country:US
Mailing Address - Phone:912-585-5209
Mailing Address - Fax:
Practice Address - Street 1:403 DURDEN ST
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474-4600
Practice Address - Country:US
Practice Address - Phone:912-585-5209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006970101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional