Provider Demographics
NPI:1518298322
Name:LEON T. WEBBER, DMN, LMFT, LLC
Entity Type:Organization
Organization Name:LEON T. WEBBER, DMN, LMFT, LLC
Other - Org Name:LEON T. WEBBER, LMFT
Other - Org Type:Other Name
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEON
Authorized Official - Middle Name:T
Authorized Official - Last Name:WEBBER
Authorized Official - Suffix:
Authorized Official - Credentials:DMN,, LMFT
Authorized Official - Phone:907-360-3111
Mailing Address - Street 1:2605 DENALI ST STE 203
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2749
Mailing Address - Country:US
Mailing Address - Phone:907-360-3111
Mailing Address - Fax:907-272-1553
Practice Address - Street 1:3851 PIPER ST STE U264
Practice Address - Street 2:PROVIDENCE CANCER CENTER, BLDG U
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-6903
Practice Address - Country:US
Practice Address - Phone:907-360-3111
Practice Address - Fax:907-272-1553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-18
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK53106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK53 AKOtherSTATE LICENSE NUMBER