Provider Demographics
NPI:1811346877
Name:WINTERS, LEON C (LCSW-BACS)
Entity type:Individual
Prefix:
First Name:LEON
Middle Name:C
Last Name:WINTERS
Suffix:
Gender:M
Credentials:LCSW-BACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 BERTRAND DR STE E3
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-9105
Mailing Address - Country:US
Mailing Address - Phone:337-962-1987
Mailing Address - Fax:
Practice Address - Street 1:1304 BERTRAND DR STE E3
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-9105
Practice Address - Country:US
Practice Address - Phone:337-962-1987
Practice Address - Fax:844-364-1683
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA118431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical