Provider Demographics
NPI:1497237648
Name:LEIGH ANN CHRISTIAN LCSW, LAC PLLC
Entity Type:Organization
Organization Name:LEIGH ANN CHRISTIAN LCSW, LAC PLLC
Other - Org Name:LEIGH ANN CHRISTIAN LCSW, LAC PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LEIGH ANN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHRISTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW LAC
Authorized Official - Phone:406-550-2329
Mailing Address - Street 1:PO BOX 17541
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-7541
Mailing Address - Country:US
Mailing Address - Phone:406-550-2329
Mailing Address - Fax:
Practice Address - Street 1:127 N HIGGINS AVE STE 307D
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4486
Practice Address - Country:US
Practice Address - Phone:406-550-2329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-04
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty