Provider Demographics
NPI:1497924674
Name:LEON, KATHERINE LEIGH (LISW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LEIGH
Last Name:LEON
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 9TH ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-2527
Mailing Address - Country:US
Mailing Address - Phone:515-288-1516
Mailing Address - Fax:515-288-0437
Practice Address - Street 1:521 E LOCUST ST
Practice Address - Street 2:SUITE 202
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1943
Practice Address - Country:US
Practice Address - Phone:515-288-1516
Practice Address - Fax:515-244-0545
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06317101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health