=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417460965
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LEANN MORRISSETTE LCDC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2017
-----------------------------------------------------
Last Update Date | 05/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 49 JOHNSON RD
-----------------------------------------------------
City | THE PLAINS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45780-1146
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 452-974-0764
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9 CHESAPEAKE PLZ
-----------------------------------------------------
City | CHESAPEAKE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45619-1003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | LICDC.162054
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 171M00000X
-----------------------------------------------------
Taxonomy Name | Case Manager/Care Coordinator
-----------------------------------------------------
License Number | LICDC.162054
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | C.2002853
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------