Provider Demographics
NPI:1811288111
Name:PRINCE, LEU ANNE (LPC)
Entity type:Individual
Prefix:MRS
First Name:LEU
Middle Name:ANNE
Last Name:PRINCE
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:PO BOX 302
Mailing Address - Street 2:402 2ND S
Mailing Address - City:BERNICE
Mailing Address - State:LA
Mailing Address - Zip Code:71222-0302
Mailing Address - Country:US
Mailing Address - Phone:318-285-9066
Mailing Address - Fax:318-285-9019
Practice Address - Street 1:402 2ND ST
Practice Address - Street 2:
Practice Address - City:BERNICE
Practice Address - State:LA
Practice Address - Zip Code:71222-0302
Practice Address - Country:US
Practice Address - Phone:318-285-9066
Practice Address - Fax:318-285-9019
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2320101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health