Provider Demographics
NPI:1003955816
Name:PIERCE, LEAH NEBLETT (CMSW)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:NEBLETT
Last Name:PIERCE
Suffix:
Gender:F
Credentials:CMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19410 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:TN
Mailing Address - Zip Code:38344-3415
Mailing Address - Country:US
Mailing Address - Phone:731-986-4411
Mailing Address - Fax:
Practice Address - Street 1:19410 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:TN
Practice Address - Zip Code:38344-3415
Practice Address - Country:US
Practice Address - Phone:731-986-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5441276Medicaid