Kelly Denisse Leader, LAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A2106018 Issued in AR

Practice address

1501 S Waldron Rd Ste 100
Fort Smith, AR 72903-2568

Phone

(479) 561-7600

Fax

(479) 434-4333

NPI assigned

May 27, 2022

Last updated

May 27, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kelly Denisse Leader Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1295474344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S WALDRON RD STE 100",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032568",
            "telephone_number": "479-259-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S WALDRON RD STE 100",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032568",
            "telephone_number": "479-561-7600",
            "fax_number": "479-434-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEADER",
        "first_name": "KELLY",
        "middle_name": "DENISSE",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-27",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "A2106018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "LEADER",
            "middle_name": "DENISSE",
            "credential": "LAC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Professional Counselor in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.