Provider Demographics
NPI:1578995130
Name:DELGADO, LEANNE ANISSA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:ANISSA
Last Name:DELGADO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:LEANNE
Other - Middle Name:ANISSA
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:30 HAZEL TER STE 25
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2240
Mailing Address - Country:US
Mailing Address - Phone:203-787-8269
Mailing Address - Fax:855-271-3607
Practice Address - Street 1:30 HAZEL TER STE 25
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2240
Practice Address - Country:US
Practice Address - Phone:203-787-8269
Practice Address - Fax:855-271-3607
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003820101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional