Provider Demographics
NPI:1225447451
Name:SMITH, LEAH MARIE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:MARIE
Other - Last Name:POLKOVITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5900 BALCONES DR # 14973
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4257
Mailing Address - Country:US
Mailing Address - Phone:803-354-7719
Mailing Address - Fax:
Practice Address - Street 1:275 BAUER LN
Practice Address - Street 2:
Practice Address - City:CASTROVILLE
Practice Address - State:TX
Practice Address - Zip Code:78009-3499
Practice Address - Country:US
Practice Address - Phone:803-354-7719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66113104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker