Provider Demographics
NPI:1639416324
Name:LEONARD, JENNIFER N (MSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:N
Last Name:LEONARD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2960 CHARTRES ST
Mailing Address - Street 2:PO BOX 1488
Mailing Address - City:LA SALLE
Mailing Address - State:IL
Mailing Address - Zip Code:61301-1097
Mailing Address - Country:US
Mailing Address - Phone:815-224-5001
Mailing Address - Fax:815-223-1634
Practice Address - Street 1:2960 CHARTRES ST
Practice Address - Street 2:
Practice Address - City:LA SALLE
Practice Address - State:IL
Practice Address - Zip Code:61301-1097
Practice Address - Country:US
Practice Address - Phone:815-224-5001
Practice Address - Fax:815-223-1634
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health