Provider Demographics
NPI:1750336715
Name:WILKINS, LEIGH JENNINGS (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LEIGH
Middle Name:JENNINGS
Last Name:WILKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4680 RUNNING BROOK TER
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-9254
Mailing Address - Country:US
Mailing Address - Phone:317-535-0513
Mailing Address - Fax:317-535-8749
Practice Address - Street 1:540 TRACY RD
Practice Address - Street 2:SUITE C
Practice Address - City:NEW WHITELAND
Practice Address - State:IN
Practice Address - Zip Code:46184-9699
Practice Address - Country:US
Practice Address - Phone:317-535-0513
Practice Address - Fax:317-535-8749
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004248A1041C0700X
GACSW0028781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000387526OtherANTHEM/BCBS
IN000000387526OtherANTHEM/BC?BS