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General NPI Number Information
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NPI Number | 1801677703
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Entity Type | Organization
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Legal Business Name | STEPHANIE LEACH, LLC
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Dates
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Enumeration Date | 10/09/2023
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Last Update Date | 10/09/2023
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Provider Practice Location Address
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Address Line | 985 BETHEL RD STE B
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City | COLUMBUS
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State | OH
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Zip | 43214-1990
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Country | US
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Telephone | 614-566-3889
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Fax |
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Provider Business Mailing Address
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Address Line | 5671 PRESTON WOODS RD
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City | COLUMBUS
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State | OH
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Zip | 43235-4020
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Country | US
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Telephone | 614-563-8551
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE LEACH
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Credential | LISW
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Telephone | 614-563-8551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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