Provider Demographics
NPI:1124762208
Name:WARNER, LEEANNA RUTH EARLY (LPC)
Entity type:Individual
Prefix:
First Name:LEEANNA
Middle Name:RUTH EARLY
Last Name:WARNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 RIVERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-1613
Mailing Address - Country:US
Mailing Address - Phone:724-944-6876
Mailing Address - Fax:
Practice Address - Street 1:1381 CROSSINGS CENTER DR STE E
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-4976
Practice Address - Country:US
Practice Address - Phone:434-219-5621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011155101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional