Provider Demographics
NPI:1356982284
Name:BOX, LEIGH (LPC)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:
Last Name:BOX
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 TOWNE CENTER PL STE 1300
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-4866
Mailing Address - Country:US
Mailing Address - Phone:601-977-9353
Mailing Address - Fax:
Practice Address - Street 1:1850 PARKRIDGE DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-6001
Practice Address - Country:US
Practice Address - Phone:601-278-4818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2429101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health