MEDICARE: LEANNA ELIZABETH BALDNER LPC-MHSP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	5763	TN

General Provider Information

NPI Number	:	1801610456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEANNA ELIZABETH BALDNER LPC-MHSP

Provider Business Mailing Address
First Line	:	7174 STAGE RD STE 123
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38133-8954
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7174 STAGE RD STE 123
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38133-8954
Country	:	US
Telephone Number	:	901-878-9355
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2024
Last Update Date	:	11/11/2024

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Directions to “ LEANNA ELIZABETH BALDNER LPC-MHSP” Practice Location

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