Provider Demographics
NPI:1477805372
Name:HESS, LEEANNE MERIN (LCSW)
Entity Type:Individual
Prefix:
First Name:LEEANNE
Middle Name:MERIN
Last Name:HESS
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 1:747 LEWIS AND CLARK CIR
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84014-3418
Mailing Address - Country:US
Mailing Address - Phone:801-390-9931
Mailing Address - Fax:
Practice Address - Street 1:1208 E 3300 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-2522
Practice Address - Country:US
Practice Address - Phone:801-483-1600
Practice Address - Fax:801-483-1610
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT276248-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical