Provider Demographics
NPI:1295076347
Name:STENSGAARD, LEANN RENE (LCSW)
Entity type:Individual
Prefix:
First Name:LEANN
Middle Name:RENE
Last Name:STENSGAARD
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 1:2404 S MORNING SUN CT
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-4918
Mailing Address - Country:US
Mailing Address - Phone:208-465-4828
Mailing Address - Fax:
Practice Address - Street 1:2404 S MORNING SUN CT
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-4918
Practice Address - Country:US
Practice Address - Phone:208-465-4828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-9881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical