Provider Demographics
NPI:1417090309
Name:LUNSFORD-HAYWOOD, LEANNE MARIE (MA,LMHC)
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:MARIE
Last Name:LUNSFORD-HAYWOOD
Suffix:
Gender:F
Credentials:MA,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 ASTREA PL
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-3957
Mailing Address - Country:US
Mailing Address - Phone:360-293-7550
Mailing Address - Fax:
Practice Address - Street 1:406 S 1ST ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-3801
Practice Address - Country:US
Practice Address - Phone:360-336-1929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005438101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health