Provider Demographics
NPI:1578670790
Name:KEYLON, LEAPHA ANNE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LEAPHA
Middle Name:ANNE
Last Name:KEYLON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13623 272ND ST NE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-6831
Mailing Address - Country:US
Mailing Address - Phone:360-631-0243
Mailing Address - Fax:360-435-6215
Practice Address - Street 1:307 N OLYMPIC AVE STE 213
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1351
Practice Address - Country:US
Practice Address - Phone:360-631-0243
Practice Address - Fax:360-435-6215
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00005243101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health