Healthcare Provider Details

I. General information

NPI: 1932757432
Provider Name (Legal Business Name): LEIGH ANNE HUTTON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LEIGH ANNE SAMPLE LPC

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 INDUSTRIAL PARK RD
CLEARFIELD PA
16830-6016
US

IV. Provider business mailing address

60 INDUSTRIAL PARK RD
CLEARFIELD PA
16830-6016
US

V. Phone/Fax

Practice location:
  • Phone: 814-765-1149
  • Fax: 814-765-9542
Mailing address:
  • Phone: 814-592-1137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number7860452
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC011694
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: