Provider Demographics
NPI:1598123242
Name:LEONARD, CHRISTINE (LAC, LPC, AADC, SAP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:LEONARD
Suffix:
Gender:
Credentials:LAC, LPC, AADC, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 FULDNER RD
Mailing Address - Street 2:
Mailing Address - City:BARNWELL
Mailing Address - State:SC
Mailing Address - Zip Code:29812-7328
Mailing Address - Country:US
Mailing Address - Phone:803-541-1245
Mailing Address - Fax:803-541-1247
Practice Address - Street 1:179 FULDNER RD
Practice Address - Street 2:
Practice Address - City:BARNWELL
Practice Address - State:SC
Practice Address - Zip Code:29812-7328
Practice Address - Country:US
Practice Address - Phone:803-541-1245
Practice Address - Fax:803-541-1247
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10522101YP2500X, 101YP2500X
SC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAD01AKMedicaid