Provider Demographics
NPI:1659716892
Name:LEONARD, HEATHER ANGEL (LPC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANGEL
Last Name:LEONARD
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 1:2430 FAIRLANE DR STE C-7
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-1641
Mailing Address - Country:US
Mailing Address - Phone:334-551-0735
Mailing Address - Fax:334-551-0767
Practice Address - Street 1:2430 FAIRLANE DR STE C-7
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-1641
Practice Address - Country:US
Practice Address - Phone:334-551-0735
Practice Address - Fax:334-551-0767
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1854101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional