Provider Demographics
NPI:1992852974
Name:HENSLEY, LEONDA (LCSW)
Entity Type:Individual
Prefix:
First Name:LEONDA
Middle Name:
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 S PINE ST
Mailing Address - Street 2:SUITE #2
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-3827
Mailing Address - Country:US
Mailing Address - Phone:501-259-1776
Mailing Address - Fax:501-255-1318
Practice Address - Street 1:705 S PINE ST
Practice Address - Street 2:SUITE #2
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-3827
Practice Address - Country:US
Practice Address - Phone:501-259-1776
Practice Address - Fax:501-255-1318
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1728C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X224Medicare ID - Type Unspecified