Provider Demographics
NPI:1356742712
Name:MCGENNIS, LEAH (LMSW)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:
Last Name:MCGENNIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DANIELSON
Mailing Address - State:CT
Mailing Address - Zip Code:06239-2816
Mailing Address - Country:US
Mailing Address - Phone:888-316-5221
Mailing Address - Fax:866-203-2138
Practice Address - Street 1:11 HIGGINS HIGHWAY
Practice Address - Street 2:SUITE 12
Practice Address - City:MANSFIELD CENTER
Practice Address - State:CT
Practice Address - Zip Code:06250-1437
Practice Address - Country:US
Practice Address - Phone:888-316-5221
Practice Address - Fax:866-203-2138
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical