Provider Demographics
NPI:1508092867
Name:LEACH, ANN T (LCSW)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:T
Last Name:LEACH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:TUCKER
Other - Last Name:DULANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 VALLEYVIEW ST
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-7729
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:133 HARMONY PARK CIR
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-5417
Practice Address - Country:US
Practice Address - Phone:501-624-7700
Practice Address - Fax:501-623-5788
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4691-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR226705719Medicaid