Healthcare Provider Details

I. General information

NPI: 1477478543
Provider Name (Legal Business Name): ALEX L LEATHERS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 MARSH AVE STE 202
RENO NV
89509-1651
US

IV. Provider business mailing address

1555 N SIERRA ST APT 235
RENO NV
89503-1728
US

V. Phone/Fax

Practice location:
  • Phone: 775-525-1584
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13285-M
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: