Provider Demographics
NPI:1336667351
Name:STEBBINS, LEAH CONDE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:CONDE
Last Name:STEBBINS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:MARIE
Other - Last Name:CONDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 ALAMEDA DEL PRADO STE 103
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94949-6698
Mailing Address - Country:US
Mailing Address - Phone:415-526-0421
Mailing Address - Fax:
Practice Address - Street 1:201 ALAMEDA DEL PRADO STE 103
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94949-6698
Practice Address - Country:US
Practice Address - Phone:415-526-0421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI119218401104100000X
CA971471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker