Healthcare Provider Details

I. General information

NPI: 1477922532
Provider Name (Legal Business Name): HEATHER LEIGH LEAHY PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2015
Last Update Date: 10/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 CONNECTICUT AVE NW SUITE 500
WASHINGTON DC
20036-1111
US

IV. Provider business mailing address

1555 CONNECTICUT AVE NW SUITE 500
WASHINGTON DC
20036-1111
US

V. Phone/Fax

Practice location:
  • Phone: 773-307-3115
  • Fax:
Mailing address:
  • Phone: 773-307-3115
  • Fax: 703-777-0170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: