Provider Demographics
NPI:1922184233
Name:LEACH, BARBARA Y (LMHC)
Entity Type:Individual
Prefix:MISS
First Name:BARBARA
Middle Name:Y
Last Name:LEACH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1018
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-1018
Mailing Address - Country:US
Mailing Address - Phone:407-370-6788
Mailing Address - Fax:407-523-9487
Practice Address - Street 1:5728 MAJOR BLVD
Practice Address - Street 2:STE 259
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7945
Practice Address - Country:US
Practice Address - Phone:407-370-6788
Practice Address - Fax:407-523-9487
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7286101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL283868Medicaid