Provider Demographics
NPI:1780956508
Name:LEINGANG, HEIDI ANNE (LPC)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:ANNE
Last Name:LEINGANG
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 1:1110 COLLEGE DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-1207
Mailing Address - Country:US
Mailing Address - Phone:701-258-2008
Mailing Address - Fax:
Practice Address - Street 1:1110 COLLEGE DR
Practice Address - Street 2:SUITE 215
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-1207
Practice Address - Country:US
Practice Address - Phone:701-258-2008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND643-15-09101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health