Provider Demographics
NPI:1609683986
Name:LEIS, ABIGAIL CECILIA (LPC)
Entity type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:CECILIA
Last Name:LEIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2470
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67504-2470
Mailing Address - Country:US
Mailing Address - Phone:316-944-3940
Mailing Address - Fax:
Practice Address - Street 1:8748 W 151ST ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66221-8705
Practice Address - Country:US
Practice Address - Phone:316-272-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04182101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional