Provider Demographics
NPI:1841260551
Name:ULLMAN, LEAH (LCSW)
Entity type:Individual
Prefix:MS
First Name:LEAH
Middle Name:
Last Name:ULLMAN
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 1:1700 ALMA DR., SUITE 480 PLANO, TX 75075
Mailing Address - Street 2:1700 ALMA DR., SUITE 480
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075
Mailing Address - Country:US
Mailing Address - Phone:972-422-2008
Mailing Address - Fax:972-422-4014
Practice Address - Street 1:1700 ALMA DR STE 480
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6924
Practice Address - Country:US
Practice Address - Phone:972-422-2008
Practice Address - Fax:972-422-4014
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0401361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00856427OtherRAILROAD MEDICARE
NYP83140Medicare UPIN
NYP00856427OtherRAILROAD MEDICARE