MEDICARE: MRS. BEVERLY LEONARDI LMHC

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	101YP2500X	Professional Counselor	CTB-2025-0775	NM

General Provider Information

NPI Number	:	1629859822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BEVERLY LEONARDI LMHC

Provider Business Mailing Address
First Line	:	1000 E 18TH ST
Second Line	:
City	:	ROSWELL
State	:	NM
Zip	:	88201-7532
Country	:	US
Telephone Number	:	575-624-1780
Fax Number	:	575-624-2033

Provider Business Practice Location Address
First Line	:	1000 E 18TH ST
Second Line	:
City	:	ROSWELL
State	:	NM
Zip	:	88201-7532
Country	:	US
Telephone Number	:	575-624-1780
Fax Number	:	575-624-2033

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

Provider Enumeration Date	:	10/12/2023
Last Update Date	:	10/17/2025

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