Provider Demographics
NPI:1528207503
Name:LEONARD, RACHEL ANN (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ANN
Last Name:LEONARD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 574
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-0010
Mailing Address - Country:US
Mailing Address - Phone:401-316-0126
Mailing Address - Fax:401-223-6883
Practice Address - Street 1:650 TEN ROD RD
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852
Practice Address - Country:US
Practice Address - Phone:401-316-0126
Practice Address - Fax:401-223-6883
Is Sole Proprietor?:No
Enumeration Date:2009-02-13
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW10501041C0700X
RIISW020951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical