Provider Demographics
NPI:1043668999
Name:PINKSTON, LEAH BEARMAN
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:BEARMAN
Last Name:PINKSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:DOROTHY
Other - Last Name:BEARMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 S FOREST ST APT 319
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1645
Mailing Address - Country:US
Mailing Address - Phone:901-258-1332
Mailing Address - Fax:
Practice Address - Street 1:8000 CENTERVIEW PKWY STE 103
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4264
Practice Address - Country:US
Practice Address - Phone:901-417-7434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
TN4372101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional