Provider Demographics
NPI:1568964245
Name:KNIGHT, LEAH (LPC)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 RUE MARSEILLE
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-1238
Mailing Address - Country:US
Mailing Address - Phone:504-919-7674
Mailing Address - Fax:
Practice Address - Street 1:60 LOUIS PRIMA DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-5903
Practice Address - Country:US
Practice Address - Phone:504-919-7674
Practice Address - Fax:985-327-8800
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3920101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health