Provider Demographics
NPI:1942803010
Name:LEFLEUR BEHAVIORAL HEALTH, PLLC
Entity Type:Organization
Organization Name:LEFLEUR BEHAVIORAL HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST & OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:RUEFF
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:601-278-5711
Mailing Address - Street 1:2332 SOUTHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-6212
Mailing Address - Country:US
Mailing Address - Phone:601-278-5711
Mailing Address - Fax:
Practice Address - Street 1:1000 HIGHLAND COLONY PKWY BLDG 5000
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-2073
Practice Address - Country:US
Practice Address - Phone:601-809-5324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS59-031OtherMISSISSIPPI PSYCHOLOGY LICENSE