Provider Demographics
NPI:1194057968
Name:LEANDRE, KIMBERLY ERIN (CAGS, LMHC)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ERIN
Last Name:LEANDRE
Suffix:
Gender:F
Credentials:CAGS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5840 POST RD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-2140
Mailing Address - Country:US
Mailing Address - Phone:401-398-7933
Mailing Address - Fax:401-398-7405
Practice Address - Street 1:5840 POST RD
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-2140
Practice Address - Country:US
Practice Address - Phone:401-499-1631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00412101Y00000X
RIMGC0041101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor