Provider Demographics
NPI:1720320203
Name:ROCKETT-DIXON, LESHAUNDA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LESHAUNDA
Middle Name:
Last Name:ROCKETT-DIXON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LESHAUNDA
Other - Middle Name:
Other - Last Name:ROCKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 413709
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-3709
Mailing Address - Country:US
Mailing Address - Phone:816-944-0858
Mailing Address - Fax:
Practice Address - Street 1:30 W PERSHING RD # 413709
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2410
Practice Address - Country:US
Practice Address - Phone:816-944-0858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20180207221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical