Provider Demographics
NPI:1982773255
Name:GOVER, LEANNE III (MSW)
Entity type:Individual
Prefix:MS
First Name:LEANNE
Middle Name:
Last Name:GOVER
Suffix:III
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1372 N. SUSQUEHANNA TRAIL
Mailing Address - Street 2:SUITE 330
Mailing Address - City:SELINSGROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17870
Mailing Address - Country:US
Mailing Address - Phone:570-743-2323
Mailing Address - Fax:570-743-2343
Practice Address - Street 1:1372 N. SUSQUEHANNA TRL
Practice Address - Street 2:SUITE 330
Practice Address - City:SELINSGROVE
Practice Address - State:PA
Practice Address - Zip Code:17870
Practice Address - Country:US
Practice Address - Phone:570-743-2323
Practice Address - Fax:570-743-2343
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0135401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical