Provider Demographics
NPI:1528579612
Name:PENNIMAN, LEIGH ANN (LMHC, CAP)
Entity Type:Individual
Prefix:MS
First Name:LEIGH
Middle Name:ANN
Last Name:PENNIMAN
Suffix:
Gender:F
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 NORTHLAKE BLVD
Mailing Address - Street 2:#210
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-5405
Mailing Address - Country:US
Mailing Address - Phone:561-814-5455
Mailing Address - Fax:561-355-5622
Practice Address - Street 1:321 NORTHLAKE BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-5405
Practice Address - Country:US
Practice Address - Phone:561-814-5455
Practice Address - Fax:561-355-5622
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLMH15127101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health