Provider Demographics
NPI:1841651262
Name:WALTER, LEEANN (LPC)
Entity type:Individual
Prefix:
First Name:LEEANN
Middle Name:
Last Name:WALTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LEEANN
Other - Middle Name:
Other - Last Name:TROUT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:10097 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-1472
Mailing Address - Country:US
Mailing Address - Phone:878-847-8041
Mailing Address - Fax:
Practice Address - Street 1:4 S 4TH ST STE 2
Practice Address - Street 2:
Practice Address - City:YOUNGWOOD
Practice Address - State:PA
Practice Address - Zip Code:15697-8203
Practice Address - Country:US
Practice Address - Phone:878-847-8041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-12
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008818101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional