Provider Demographics
NPI:1518187855
Name:LEACH, DAVID PATRICK (BA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:PATRICK
Last Name:LEACH
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 NAPLES AVE
Mailing Address - Street 2:
Mailing Address - City:CAYCE
Mailing Address - State:SC
Mailing Address - Zip Code:29033-3608
Mailing Address - Country:US
Mailing Address - Phone:803-605-8103
Mailing Address - Fax:
Practice Address - Street 1:800 NAPLES AVE
Practice Address - Street 2:
Practice Address - City:CAYCE
Practice Address - State:SC
Practice Address - Zip Code:29033-3608
Practice Address - Country:US
Practice Address - Phone:803-898-2025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health