Provider Demographics
NPI:1568264380
Name:LEAP, MACEY AMANDA (MED, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:MACEY
Middle Name:AMANDA
Last Name:LEAP
Suffix:
Gender:
Credentials:MED, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 BRITTANY CV
Mailing Address - Street 2:
Mailing Address - City:COTTLEVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63304-7168
Mailing Address - Country:US
Mailing Address - Phone:636-284-0911
Mailing Address - Fax:
Practice Address - Street 1:111 CHESTERFIELD TOWNE CTR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1230
Practice Address - Country:US
Practice Address - Phone:573-208-7900
Practice Address - Fax:573-208-7900
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025008454103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst