Provider Demographics
NPI:1942610050
Name:LEACH, CINDY (MSSW)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:
Last Name:LEACH
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:A
Other - Last Name:STOBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:1225 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:TN
Mailing Address - Zip Code:37058-3352
Mailing Address - Country:US
Mailing Address - Phone:931-232-5138
Mailing Address - Fax:
Practice Address - Street 1:1225 SPRING ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:TN
Practice Address - Zip Code:37058-3352
Practice Address - Country:US
Practice Address - Phone:931-232-5138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2537104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker