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General NPI Number Information
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NPI Number | 1457993057
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Entity Type | Individual
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Provider Name | JOSEPH STEPHEN LEONARD LMFT-T
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Gender | Male
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Dates
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Enumeration Date | 10/15/2019
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Last Update Date | 10/15/2019
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Provider Practice Location Address
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Address Line | 8025 EXCELSIOR DR STE 110
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City | MADISON
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State | WI
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Zip | 53717-2902
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Country | US
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Telephone | 608-663-6154
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Fax |
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Provider Business Mailing Address
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Address Line | 7809 STRATTON WAY
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City | MADISON
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State | WI
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Zip | 53719-5811
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Country | US
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Telephone | 262-893-9041
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 681228
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License Number State | WI
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