Provider Demographics
NPI:1679099485
Name:LEENAY PSYCHOLOGY CONSULTANTS LLC
Entity Type:Organization
Organization Name:LEENAY PSYCHOLOGY CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEENAY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD PSYCHOLOGIST
Authorized Official - Phone:316-616-0260
Mailing Address - Street 1:9333 EAST HARRY STREET
Mailing Address - Street 2:101
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-1406
Mailing Address - Country:US
Mailing Address - Phone:316-461-1933
Mailing Address - Fax:316-869-1783
Practice Address - Street 1:727 N WACO AVE STE 210
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-3953
Practice Address - Country:US
Practice Address - Phone:316-616-0260
Practice Address - Fax:316-616-0264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1719103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty