Provider Demographics
NPI:1184994972
Name:CULBERTSON, LEEANN MICHELE (CM II)
Entity type:Individual
Prefix:MRS
First Name:LEEANN
Middle Name:MICHELE
Last Name:CULBERTSON
Suffix:
Gender:F
Credentials:CM II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 W MINER ST
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-2922
Mailing Address - Country:US
Mailing Address - Phone:530-841-1783
Mailing Address - Fax:530-841-0769
Practice Address - Street 1:326 W MINER ST
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-2922
Practice Address - Country:US
Practice Address - Phone:530-841-1783
Practice Address - Fax:530-841-0769
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker