Provider Demographics
NPI:1821516675
Name:MEADE-JOHNSON, LEIGH ANN (CDCA)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANN
Last Name:MEADE-JOHNSON
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4342 GALLIA ST STE A
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-5563
Mailing Address - Country:US
Mailing Address - Phone:740-529-1184
Mailing Address - Fax:740-876-4118
Practice Address - Street 1:3896 COUNTY ROAD 15
Practice Address - Street 2:
Practice Address - City:SOUTH POINT
Practice Address - State:OH
Practice Address - Zip Code:45680-7592
Practice Address - Country:US
Practice Address - Phone:740-529-1184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH161860101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)