Provider Demographics
NPI:1245844505
Name:KANE, LEANN VI (LISW)
Entity type:Individual
Prefix:
First Name:LEANN
Middle Name:
Last Name:KANE
Suffix:VI
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2885 LINDALE MOUNT HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:AMELIA
Mailing Address - State:OH
Mailing Address - Zip Code:45102-9707
Mailing Address - Country:US
Mailing Address - Phone:859-608-0785
Mailing Address - Fax:
Practice Address - Street 1:7000 HOUSTON RD STE 29
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4879
Practice Address - Country:US
Practice Address - Phone:859-746-9272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI18011771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical