Provider Demographics
NPI:1639542343
Name:SCHICK, LEONA MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:LEONA
Middle Name:MARIE
Last Name:SCHICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 672392
Mailing Address - Street 2:
Mailing Address - City:CHUGIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99567-2392
Mailing Address - Country:US
Mailing Address - Phone:907-729-4955
Mailing Address - Fax:907-729-4978
Practice Address - Street 1:4501 DIPLOMACY DRIVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-729-4955
Practice Address - Fax:907-729-4978
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK11521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical