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General NPI Number Information
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NPI Number | 1700060191
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Entity Type | Organization
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Legal Business Name | LEAHY & ASSOCIATES, P.C.
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 12/21/2007
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Provider Practice Location Address
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Address Line | 475 DUNHAM RD, SUITE G
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City | ST. CHARLES
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State | IL
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Zip | 60174-2200
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Country | US
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Telephone | 630-849-3711
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Fax |
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Provider Business Mailing Address
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Address Line | 475 DUNHAM RD, SUITE G
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City | ST. CHARLES
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State | IL
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Zip | 60174-2200
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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 | PRESIDENT
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Name | MRS. MEGAN LEAHY
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Credential | MSW, LCSW
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Telephone | 630-849-3711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | IL
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