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General NPI Number Information
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NPI Number | 1891269866
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Entity Type | Individual
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Provider Name | DEBORAH JEAN LEAHY R.N., L.M.H.C.
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Gender | Female
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Dates
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Enumeration Date | 01/14/2019
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 18501 MURDOCK CIR STE 104
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-4002
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Country | US
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Telephone | 941-204-9038
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Fax |
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Provider Business Mailing Address
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Address Line | 23291 MOORHEAD AVE
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City | PORT CHARLOTTE
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State | FL
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Zip | 33954-2555
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Country | US
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Telephone | 941-204-9038
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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 | MH16569
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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