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General NPI Number Information
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NPI Number | 1588486773
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Entity Type | Individual
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Provider Name | EDWINA LEONARD MS, LPC-A
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Gender | Female
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 86277 MAINLINE RD
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City | YULEE
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State | FL
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Zip | 32097-0052
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Country | US
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Telephone | 678-793-7522
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Fax |
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Provider Business Mailing Address
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Address Line | 6650 RIVERS AVE STE 100
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-4809
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 9118
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License Number State | SC
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