Provider Demographics
NPI:1821424565
Name:LEESON, KASEY MICHELE (LMSW)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:MICHELE
Last Name:LEESON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KASEY
Other - Middle Name:MICHELE
Other - Last Name:DAVENPORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:QBHP
Mailing Address - Street 1:1500 N MISSISSIPPI ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-5851
Mailing Address - Country:US
Mailing Address - Phone:501-217-8600
Mailing Address - Fax:
Practice Address - Street 1:1500 N MISSISSIPPI ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-5851
Practice Address - Country:US
Practice Address - Phone:501-217-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR12035-M104100000X
AR104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker