Provider Demographics
NPI:1760470694
Name:BARNES, LEIGH A (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LEIGH
Middle Name:A
Last Name:BARNES
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 BROADWAY
Mailing Address - Street 2:BRAODFIELD CENTER, SUITE N
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-8122
Mailing Address - Country:US
Mailing Address - Phone:219-707-5518
Mailing Address - Fax:
Practice Address - Street 1:9111 BROADWAY
Practice Address - Street 2:BRAODFIELD CENTER, SUITE N
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-8122
Practice Address - Country:US
Practice Address - Phone:219-707-5518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN101YS0200X
IL21506111041S0200X
IN34005249A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000320726OtherANTHEM