Provider Demographics
NPI:1053024059
Name:LEIGH ANN RICHARDSON LPC LLC
Entity type:Organization
Organization Name:LEIGH ANN RICHARDSON LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:GERMANY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:601-212-0600
Mailing Address - Street 1:407 FONTAINE PL STE 101
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-5170
Mailing Address - Country:US
Mailing Address - Phone:601-707-9806
Mailing Address - Fax:
Practice Address - Street 1:407 FONTAINE PL STE 101
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-5170
Practice Address - Country:US
Practice Address - Phone:601-707-9806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty