Provider Demographics
NPI:1508454653
Name:PURYEAR, LEAHA MARIE (LPCC)
Entity type:Individual
Prefix:
First Name:LEAHA
Middle Name:MARIE
Last Name:PURYEAR
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:LEAHA
Other - Middle Name:MARIE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:505 HECKS PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-8423
Mailing Address - Country:US
Mailing Address - Phone:606-432-1327
Mailing Address - Fax:
Practice Address - Street 1:505 HECKS PLAZA DR
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-8423
Practice Address - Country:US
Practice Address - Phone:606-462-1327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY101YP2500XMedicaid