Provider Demographics
NPI:1295785954
Name:BRUCE, LEANN ELIZABETH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LEANN
Middle Name:ELIZABETH
Last Name:BRUCE
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 1:1439 HINTON HILLS LOOP
Mailing Address - Street 2:
Mailing Address - City:HARDINSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40143-6371
Mailing Address - Country:US
Mailing Address - Phone:270-257-0907
Mailing Address - Fax:270-257-8088
Practice Address - Street 1:BUILDING 851
Practice Address - Street 2:
Practice Address - City:FORT KNOX
Practice Address - State:KY
Practice Address - Zip Code:40121
Practice Address - Country:US
Practice Address - Phone:502-624-0708
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1683101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health