Healthcare Provider Details

I. General information

NPI: 1063570489
Provider Name (Legal Business Name): LEANNE DOROTHY MILLSAP LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N OCOTILLO DR
APACHE JUNCTION AZ
85220-3740
US

IV. Provider business mailing address

150 N OCOTILLO DR
APACHE JUNCTION AZ
85220-3740
US

V. Phone/Fax

Practice location:
  • Phone: 480-983-0571
  • Fax:
Mailing address:
  • Phone: 480-983-0517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLMSW010028
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12247
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: