Provider Demographics
NPI:1750068771
Name:LEONARD, BRIANNA MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MARIE
Last Name:LEONARD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:MARIE
Other - Last Name:CARROLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 NORWEGIAN PLAZA
Mailing Address - Street 2:SUITE 200
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-3946
Mailing Address - Country:US
Mailing Address - Phone:570-621-8649
Mailing Address - Fax:
Practice Address - Street 1:1 NORWEGIAN PLAZA
Practice Address - Street 2:SUITE 200
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3946
Practice Address - Country:US
Practice Address - Phone:570-628-3323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF001151106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist