Provider Demographics
NPI:1407088669
Name:LEONCAVALLO, GIANNA CLAUDIA (MA)
Entity type:Individual
Prefix:
First Name:GIANNA
Middle Name:CLAUDIA
Last Name:LEONCAVALLO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 94TH DR SE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-6620
Mailing Address - Country:US
Mailing Address - Phone:425-535-6129
Mailing Address - Fax:425-535-6129
Practice Address - Street 1:1417 94TH DR SE
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-6620
Practice Address - Country:US
Practice Address - Phone:425-535-6129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60166787101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health