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NPI Code Detail

MEDICARE: ALICE D LECKENBY MA, LPC, RPT-S

MEDICARE: ALICE D LECKENBY MA, LPC, RPT-S
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
1101YP2500XProfessional CounselorLPC.0013265CO
2101YP2500XProfessional Counselor2020033144MO

General Provider Information

NPI Number : 1629523469
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICE D LECKENBY MA, LPC, RPT-S
Provider Business Mailing Address
First Line : 19796 WHITE OAK TRL
Second Line :
City : KIRKSVILLE
State : MO
Zip : 63501-7164
Country : US
Telephone Number : 660-280-9924
Fax Number :
Provider Business Practice Location Address
First Line : 900 E LAHARPE ST
Second Line :
City : KIRKSVILLE
State : MO
Zip : 63501-4520
Country : US
Telephone Number : 660-665-1962
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2016
Last Update Date : 01/26/2026

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