Provider Demographics
NPI:1568848273
Name:LEONARD, DEENA RICHELLE (LMHC)
Entity Type:Individual
Prefix:
First Name:DEENA
Middle Name:RICHELLE
Last Name:LEONARD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 SE 11TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-5324
Mailing Address - Country:US
Mailing Address - Phone:515-282-9377
Mailing Address - Fax:515-282-6162
Practice Address - Street 1:918 SE 11TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-5324
Practice Address - Country:US
Practice Address - Phone:515-282-9377
Practice Address - Fax:515-282-6162
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001164101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health