Provider Demographics
NPI:1760368336
Name:PINA- LEACH, CELESE (LCSW, LMT)
Entity type:Individual
Prefix:
First Name:CELESE
Middle Name:
Last Name:PINA- LEACH
Suffix:
Gender:F
Credentials:LCSW, LMT
Other - Prefix:
Other - First Name:CELESE
Other - Middle Name:
Other - Last Name:PINA-LEACH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CELESE PINA
Mailing Address - Street 1:130 CALDWELL ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-1004
Mailing Address - Country:US
Mailing Address - Phone:210-589-2758
Mailing Address - Fax:
Practice Address - Street 1:130 CALDWELL ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-1004
Practice Address - Country:US
Practice Address - Phone:210-589-2758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX595861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical