Provider Demographics
NPI:1942675574
Name:CASPER, LEEANNE (LPC)
Entity Type:Individual
Prefix:
First Name:LEEANNE
Middle Name:
Last Name:CASPER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 MALLET HILL RD
Mailing Address - Street 2:APT. 11107
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-4471
Mailing Address - Country:US
Mailing Address - Phone:682-225-5618
Mailing Address - Fax:
Practice Address - Street 1:751 MALLET HILL RD
Practice Address - Street 2:APT. 11107
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-4471
Practice Address - Country:US
Practice Address - Phone:682-225-5618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6253101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health