Healthcare Provider Details

I. General information

NPI: 1801610456
Provider Name (Legal Business Name): LEANNA ELIZABETH BALDNER LPC-MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 POPLAR AVE STE 1130
MEMPHIS TN
38157-2001
US

IV. Provider business mailing address

6203 HADDINGTON DR
MEMPHIS TN
38119-7552
US

V. Phone/Fax

Practice location:
  • Phone: 601-880-3306
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5763
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5763
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: