| Doctor Name: | MR. JOHN J LEACH |
| NPI Number: | 1003823824 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW., CART |
| License Number: | 19462 |
| Business Practice Address: | 12416 Hymeadow Dr Ste 207 Austin, TX - 787502283 |
| Business Phone Number: | 8775191144 |
| Business Fax Number: | 2545191155 |
| Mailing Address: | 1010 W Jasper Dr Ste 9, KILLEEN |
| State: | TX |
| Postal Code: | 765421328 |
| Phone Number: | 2545191144 |
| Fax Number: | 2545191155 |
| NPI Enumeration Date: | 08/02/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 19462 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |