Provider Demographics
NPI:1871358150
Name:LEUENBERGER, JODIE (MSW)
Entity type:Individual
Prefix:
First Name:JODIE
Middle Name:
Last Name:LEUENBERGER
Suffix:
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 1:1917 5TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-2011
Mailing Address - Country:US
Mailing Address - Phone:509-954-3035
Mailing Address - Fax:
Practice Address - Street 1:1917 5TH ST APT A
Practice Address - Street 2:
Practice Address - City:CHENEY
Practice Address - State:WA
Practice Address - Zip Code:99004-2011
Practice Address - Country:US
Practice Address - Phone:509-954-3035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical