Individual
DR. LEANETTE HENAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DBH. LCSW, LISAC
Contact information
Practice address
3039 W PEORIA AVE, STE 102-429, PHOENIX, AZ 85029-5212
(602) 469-9040
Mailing address
3039 W PEORIA AVE, STE 102-429, PHOENIX, AZ 85029-5212
(602) 469-9040
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-11452
AZ
1041C0700X
Clinical Social Worker
Primary
LCSW-13621
AZ
Other
Enumeration date
02/02/2016
Last updated
09/03/2020
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