Provider Demographics
NPI:1285206862
Name:LEONARD, WENDY LEE (LCSW)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LEE
Last Name:LEONARD
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 1:446 FM 3042
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:75686-7371
Mailing Address - Country:US
Mailing Address - Phone:903-767-0890
Mailing Address - Fax:
Practice Address - Street 1:446 FM 3042
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:TX
Practice Address - Zip Code:75686-7371
Practice Address - Country:US
Practice Address - Phone:903-767-0890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR9758-C1041C0700X
TX628051041C0700X, 102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst