Provider Demographics
NPI:1790793099
Name:SMITH, LEANNE SUSAN (PHD LMHC)
Entity Type:Individual
Prefix:DR
First Name:LEANNE
Middle Name:SUSAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD LMHC
Other - Prefix:DR
Other - First Name:LEANNE
Other - Middle Name:SUSAN
Other - Last Name:KIMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 SE 6TH ST
Mailing Address - Street 2:STE 2
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994
Mailing Address - Country:US
Mailing Address - Phone:772-288-7370
Mailing Address - Fax:772-288-7370
Practice Address - Street 1:104 SE 6TH ST
Practice Address - Street 2:STE 2
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994
Practice Address - Country:US
Practice Address - Phone:772-288-7370
Practice Address - Fax:772-288-7370
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH3950101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health