MEDICARE: MRS. JULIA MARIE LEONARD LPC

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	64206	TX

General Provider Information

NPI Number	:	1639333289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIA MARIE LEONARD LPC

Provider Business Mailing Address
First Line	:	1025 JOHNSON ST
Second Line	:
City	:	BENBROOK
State	:	TX
Zip	:	76126-2629
Country	:	US
Telephone Number	:	817-905-6926
Fax Number	:

Provider Business Practice Location Address
First Line	:	295 E RENFRO ST STE 300
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-3954
Country	:	US
Telephone Number	:	817-693-1399
Fax Number	:

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

Provider Enumeration Date	:	07/14/2008
Last Update Date	:	02/11/2025

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