MEDICARE: MS. ANJANETTE MARIE LEONARD LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1114933058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANJANETTE MARIE LEONARD LCSW

Provider Business Mailing Address
First Line	:	24 CHESTNUT HILL RD
Second Line	:
City	:	UNCASVILLE
State	:	CT
Zip	:	06382
Country	:	US
Telephone Number	:	860-848-3825
Fax Number	:

Provider Business Practice Location Address
First Line	:	441 SALEM TPKE
Second Line	:
City	:	BOZRAH
State	:	CT
Zip	:	06334-1517
Country	:	US
Telephone Number	:	860-886-3539
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	02/21/2019

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