Provider Demographics
NPI:1598429508
Name:WHITE, LEANNA DENISE (LICSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:LEANNA
Middle Name:DENISE
Last Name:WHITE
Suffix:
Gender:F
Credentials:LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 BROOKS DR APT 204
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-5508
Mailing Address - Country:US
Mailing Address - Phone:304-710-4980
Mailing Address - Fax:
Practice Address - Street 1:1905 BROOKS DR APT 204
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-5508
Practice Address - Country:US
Practice Address - Phone:304-710-4980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23451104100000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker