Provider Demographics
NPI:1528795101
Name:BARKLEY, LEANNA MARIE (LSW)
Entity type:Individual
Prefix:
First Name:LEANNA
Middle Name:MARIE
Last Name:BARKLEY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:LEANNA
Other - Middle Name:MARIE
Other - Last Name:BARKLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSW
Mailing Address - Street 1:1708 DIME RD
Mailing Address - Street 2:
Mailing Address - City:VANDERGRIFT
Mailing Address - State:PA
Mailing Address - Zip Code:15690-8132
Mailing Address - Country:US
Mailing Address - Phone:724-858-5876
Mailing Address - Fax:
Practice Address - Street 1:1 NORTHGATE SQ
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1341
Practice Address - Country:US
Practice Address - Phone:724-689-6118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA139521104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty