Provider Demographics
NPI:1992479778
Name:HERRERA, LEONARD (LCSW)
Entity type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:
Last Name:HERRERA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2402 AIKEN ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78237-4403
Mailing Address - Country:US
Mailing Address - Phone:210-992-6204
Mailing Address - Fax:
Practice Address - Street 1:12455 FREEDOM WAY RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-3526
Practice Address - Country:US
Practice Address - Phone:210-838-6342
Practice Address - Fax:210-838-6324
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX577621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical