Provider Demographics
NPI:1528213980
Name:GIP, MUI LEANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:MUI
Middle Name:LEANNE
Last Name:GIP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1676 E PALO ALTO AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-4243
Mailing Address - Country:US
Mailing Address - Phone:209-247-2206
Mailing Address - Fax:
Practice Address - Street 1:5730 N 1ST ST
Practice Address - Street 2:# 105-552
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-6200
Practice Address - Country:US
Practice Address - Phone:209-247-2206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS219251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical