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NPI Code Detail

MEDICARE: AUSTIN ARDEE LEIGHTON

MEDICARE: AUSTIN ARDEE LEIGHTON
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
1101YA0400XAddiction (Substance Use Disorder) Counselor13546TX
2101YM0800XMental Health Counselor77272TX

General Provider Information

NPI Number : 1578087037
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUSTIN ARDEE LEIGHTON
Provider Business Mailing Address
First Line : 11504 SUNNYSIDE DR
Second Line :
City : MONT BELVIEU
State : TX
Zip : 77523-9601
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3100 EDLOE ST
Second Line :
City : HOUSTON
State : TX
Zip : 77027-6030
Country : US
Telephone Number : 713-730-9327
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2017
Last Update Date : 07/26/2017

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Directions to “ AUSTIN ARDEE LEIGHTON ” Practice Location

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