Provider Demographics
NPI:1316775596
Name:LECKRONE, KIMBERLY LINET (MSW)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:LINET
Last Name:LECKRONE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4055 COPPERFIELD RDG
Mailing Address - Street 2:
Mailing Address - City:EARLYSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22936-2468
Mailing Address - Country:US
Mailing Address - Phone:434-249-6917
Mailing Address - Fax:
Practice Address - Street 1:4055 COPPERFIELD RDG
Practice Address - Street 2:
Practice Address - City:EARLYSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22936-2468
Practice Address - Country:US
Practice Address - Phone:434-249-6917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health