Provider Demographics
NPI:1558923243
Name:HENNEKE, LEIGH ANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:LEIGH
Middle Name:ANN
Last Name:HENNEKE
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 1:5808 HIGH FOREST DR
Mailing Address - Street 2:
Mailing Address - City:MC CALLA
Mailing Address - State:AL
Mailing Address - Zip Code:35111-4207
Mailing Address - Country:US
Mailing Address - Phone:205-531-3436
Mailing Address - Fax:
Practice Address - Street 1:15 SOUTHLAKE LN STE 318
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-3328
Practice Address - Country:US
Practice Address - Phone:205-502-7219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2241101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional