Provider Demographics
NPI:1487937728
Name:LEECH, SHAWNA RENEE (MSW, LSW)
Entity type:Individual
Prefix:MS
First Name:SHAWNA
Middle Name:RENEE
Last Name:LEECH
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 MCCULLY ST
Mailing Address - Street 2:APT 7
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216-1532
Mailing Address - Country:US
Mailing Address - Phone:412-720-5061
Mailing Address - Fax:
Practice Address - Street 1:1000 CLIFFMINE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15275-1022
Practice Address - Country:US
Practice Address - Phone:412-788-4224
Practice Address - Fax:412-788-4487
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1268451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical