Provider Demographics
NPI:1265697056
Name:LEONARD, LEA (LCSW)
Entity type:Individual
Prefix:
First Name:LEA
Middle Name:
Last Name:LEONARD
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 1:2590 GOLDEN GATE PKWY STE 108
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-3204
Mailing Address - Country:US
Mailing Address - Phone:239-287-0810
Mailing Address - Fax:239-231-4189
Practice Address - Street 1:2590 GOLDEN GATE PKWY STE 108
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-3204
Practice Address - Country:US
Practice Address - Phone:239-287-0810
Practice Address - Fax:239-231-4189
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW90721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical