Provider Demographics
NPI:1598109746
Name:VERNIA-AMEND, LEAH NADINE (LPC)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:NADINE
Last Name:VERNIA-AMEND
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 1:11503 WEST COUNTY ROAD 52
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707
Mailing Address - Country:US
Mailing Address - Phone:972-935-2171
Mailing Address - Fax:
Practice Address - Street 1:401 E ILLINOIS AVE
Practice Address - Street 2:STE 400
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-4803
Practice Address - Country:US
Practice Address - Phone:432-570-3300
Practice Address - Fax:432-570-3346
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64048101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health