Provider Demographics
NPI:1730548876
Name:LEONARD, KURT M (MSW, LICSWA, MHP)
Entity type:Individual
Prefix:MR
First Name:KURT
Middle Name:M
Last Name:LEONARD
Suffix:
Gender:M
Credentials:MSW, LICSWA, MHP
Other - Prefix:MR
Other - First Name:KURT
Other - Middle Name:M
Other - Last Name:LEONARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LICSWA, MHP
Mailing Address - Street 1:9507 N DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1248
Mailing Address - Country:US
Mailing Address - Phone:509-466-0117
Mailing Address - Fax:
Practice Address - Street 1:9507 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1248
Practice Address - Country:US
Practice Address - Phone:509-466-0117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health