Provider Demographics
NPI:1821432220
Name:DODSON GOLDSTINE, LEIGH ANNE (MS LPC/MHSP)
Entity Type:Individual
Prefix:
First Name:LEIGH ANNE
Middle Name:
Last Name:DODSON GOLDSTINE
Suffix:
Gender:F
Credentials:MS LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4038 GAP RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-5903
Mailing Address - Country:US
Mailing Address - Phone:865-809-9893
Mailing Address - Fax:865-321-8833
Practice Address - Street 1:4038 GAP RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-5903
Practice Address - Country:US
Practice Address - Phone:865-809-9893
Practice Address - Fax:865-321-8833
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000589101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional