Doctor Name: | CARRIE LEACH |
NPI Number: | 1891115051 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LGSW |
License Number: | 16046 |
Business Practice Address: | 6707 Whitestone Rd Ste 106 Woodlawn, MD - 212074140 |
Business Phone Number: | 4102658737 |
Business Fax Number: | |
Mailing Address: | 1301 Richardson St, BALTIMORE |
State: | MD |
Postal Code: | 212305320 |
Phone Number: | 4439851817 |
Fax Number: | |
NPI Enumeration Date: | 04/25/2014 |
NPI Last Update Date: | 04/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 16046 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |