Doctor Name: | DR. MELINDA GOODWIN LEASEBURG |
NPI Number: | 1376650051 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD, LPC-S |
License Number: | |
Business Practice Address: | 1212 Stonehollow Dr Ste 101 Kingwood, TX - 773392149 |
Business Phone Number: | 2819957753 |
Business Fax Number: | 2819731573 |
Mailing Address: | 1212 Stonehollow Dr Ste 101, KINGWOOD |
State: | TX |
Postal Code: | 773392149 |
Phone Number: | 2819957753 |
Fax Number: | 2819731573 |
NPI Enumeration Date: | 08/25/2006 |
NPI Last Update Date: | 03/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |