Provider Demographics
NPI:1114270238
Name:TEAGUE, LEIGH ANN HINTON (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LEIGH ANN
Middle Name:HINTON
Last Name:TEAGUE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 HARRIS DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-4222
Mailing Address - Country:US
Mailing Address - Phone:662-513-9936
Mailing Address - Fax:
Practice Address - Street 1:2005 HARRIS DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-4222
Practice Address - Country:US
Practice Address - Phone:662-513-9936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-26
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC78981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical