Provider Demographics
NPI:1417983784
Name:LEOCHA, PATRICIA R (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:R
Last Name:LEOCHA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:R
Other - Last Name:PILEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:800 N JUSTICE ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3410
Mailing Address - Country:US
Mailing Address - Phone:828-694-7696
Mailing Address - Fax:828-694-7654
Practice Address - Street 1:800 N JUSTICE ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3410
Practice Address - Country:US
Practice Address - Phone:828-694-7696
Practice Address - Fax:828-694-7654
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW013032104100000X
NCC0066481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA23704Medicare ID - Type Unspecified