Provider Demographics
NPI:1720569742
Name:LEACH, JOANIE TEDESCHI (LPC)
Entity Type:Individual
Prefix:
First Name:JOANIE
Middle Name:TEDESCHI
Last Name:LEACH
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 1:8513 SHALLOWFORD LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2538
Mailing Address - Country:US
Mailing Address - Phone:972-832-7017
Mailing Address - Fax:
Practice Address - Street 1:11955 DALLAS PKWY
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4293
Practice Address - Country:US
Practice Address - Phone:214-396-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60858101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty