Provider Demographics
NPI:1558542480
Name:LEONARD, WILLIAM T III (PSYD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:T
Last Name:LEONARD
Suffix:III
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6602 CHURCH HILL ROAD
Mailing Address - Street 2:STE. 500
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620
Mailing Address - Country:US
Mailing Address - Phone:410-778-5550
Mailing Address - Fax:410-778-0984
Practice Address - Street 1:6602 CHURCH HILL ROAD
Practice Address - Street 2:STE. 500
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620
Practice Address - Country:US
Practice Address - Phone:410-778-5550
Practice Address - Fax:410-778-0984
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04419103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist