Provider Demographics
NPI:1518288018
Name:MESSERSMITH, LELAND W (LCSW)
Entity Type:Individual
Prefix:MR
First Name:LELAND
Middle Name:W
Last Name:MESSERSMITH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:LEE
Other - Middle Name:W
Other - Last Name:MESSERSMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:306 N 1500 E
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84040-4558
Mailing Address - Country:US
Mailing Address - Phone:801-698-8119
Mailing Address - Fax:
Practice Address - Street 1:58 S 950 W
Practice Address - Street 2:
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-4424
Practice Address - Country:US
Practice Address - Phone:801-698-8119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7756277-35061041C0700X
UT773496135011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical