Provider Demographics
NPI:1972985927
Name:LEONG, PATRICK (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:LEONG
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 S LETA RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-0714
Mailing Address - Country:US
Mailing Address - Phone:505-615-5226
Mailing Address - Fax:
Practice Address - Street 1:23403 E MISSION AVE STE 220H
Practice Address - Street 2:
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-5112
Practice Address - Country:US
Practice Address - Phone:509-506-3811
Practice Address - Fax:509-506-3822
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-26
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-09253104100000X
NMX-09165104100000X
WALW60845284104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker