Provider Demographics
NPI:1649559667
Name:RICE, LEEANNA (LCSWA)
Entity Type:Individual
Prefix:
First Name:LEEANNA
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 SAPPHIRE CT
Mailing Address - Street 2:STE 110
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-9079
Mailing Address - Country:US
Mailing Address - Phone:252-830-7540
Mailing Address - Fax:252-413-0932
Practice Address - Street 1:825 GUM BRANCH RD
Practice Address - Street 2:SUITE 117
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-6298
Practice Address - Country:US
Practice Address - Phone:910-939-5923
Practice Address - Fax:910-939-4403
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0093651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical