Provider Demographics
NPI:1194485565
Name:LEONARD, JOSEPH WILLIAM (LPC-A)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:WILLIAM
Last Name:LEONARD
Suffix:
Gender:M
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13330 LEOPARD ST STE 34
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-4481
Mailing Address - Country:US
Mailing Address - Phone:361-446-6460
Mailing Address - Fax:
Practice Address - Street 1:13330 LEOPARD ST STE 34
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-4481
Practice Address - Country:US
Practice Address - Phone:361-446-6460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85630101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health