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General NPI Number Information
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NPI Number | 1750682969
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Entity Type | Individual
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Provider Name | LEANNE PETERSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 02/21/2022
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Provider Practice Location Address
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Address Line | 4119 MONTROSE BLVD STE 450
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City | HOUSTON
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State | TX
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Zip | 77006-4966
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Country | US
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Telephone | 713-352-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 945 MCKINNEY ST # 21010
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City | HOUSTON
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State | TX
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Zip | 77002-6308
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Country | US
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Telephone | 713-352-0600
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 58.008846
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 61226
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License Number State | TX
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