Provider Demographics
NPI:1427862499
Name:DERIGNE, LEAANNE (MSW, PHD)
Entity type:Individual
Prefix:DR
First Name:LEAANNE
Middle Name:
Last Name:DERIGNE
Suffix:
Gender:F
Credentials:MSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 ANCHOR PT
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-1772
Mailing Address - Country:US
Mailing Address - Phone:314-341-3000
Mailing Address - Fax:
Practice Address - Street 1:21301 POWERLINE RD STE 209
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2390
Practice Address - Country:US
Practice Address - Phone:561-331-4770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-01
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW21442101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health