Provider Demographics
NPI:1871527085
Name:DIPPOLD, LEAH MARY (LCSW)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:MARY
Last Name:DIPPOLD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:MARY
Other - Last Name:SCHOLDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:110 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:RIDGWAY
Mailing Address - State:PA
Mailing Address - Zip Code:15853-1939
Mailing Address - Country:US
Mailing Address - Phone:814-776-0250
Mailing Address - Fax:814-776-1470
Practice Address - Street 1:220 PARADE ST
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-1253
Practice Address - Country:US
Practice Address - Phone:814-776-0250
Practice Address - Fax:814-776-1470
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW000724L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical