Provider Demographics
NPI:1699451047
Name:CERTION, LEAH NECOLE
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:NECOLE
Last Name:CERTION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 GRASSMERE PARK STE 116
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-3678
Mailing Address - Country:US
Mailing Address - Phone:615-866-8922
Mailing Address - Fax:
Practice Address - Street 1:640 GRASSMERE PARK STE 116
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-3678
Practice Address - Country:US
Practice Address - Phone:615-866-8922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
TN1-24-76500103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician