MEDICARE: MS. LEAH INGRAHAM 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	12571-C	AR

General Provider Information

NPI Number	:	1861334088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LEAH INGRAHAM LCSW

Provider Business Mailing Address
First Line	:	1619 ROCKWATER BLVD APT 204
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72114-3971
Country	:	US
Telephone Number	:	206-478-4533
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 FORT ROOTS DR
Second Line	:	BLDG 170, OFFICE 3L-155
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72114
Country	:	US
Telephone Number	:	501-257-3450
Fax Number	:

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

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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