MEDICARE: LEIGH REINEKE 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	09929779	CO

General Provider Information

NPI Number	:	1962074427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEIGH REINEKE LCSW

Provider Business Mailing Address
First Line	:	1945 BLUE YONDER WAY
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-1974
Country	:	US
Telephone Number	:	970-889-1910
Fax Number	:

Provider Business Practice Location Address
First Line	:	1945 BLUE YONDER WAY
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-1974
Country	:	US
Telephone Number	:	970-889-1910
Fax Number	:

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

Provider Enumeration Date	:	07/14/2021
Last Update Date	:	09/26/2023

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