Provider Demographics
NPI:1568923019
Name:STEVERSON, LEAH M (LISW-S)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:M
Last Name:STEVERSON
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10901 REED HARTMAN HWY STE 109
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-2847
Mailing Address - Country:US
Mailing Address - Phone:513-351-1402
Mailing Address - Fax:
Practice Address - Street 1:10901 REED HARTMAN HWY STE 109
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-2847
Practice Address - Country:US
Practice Address - Phone:513-351-1402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-27
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1600856104100000X
OHI.20021241041C0700X
OHI.2002124-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker