Provider Demographics
NPI:1023580016
Name:BAUER, LEIGH A (LCPC)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:A
Last Name:BAUER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 BRAGDON RD
Mailing Address - Street 2:
Mailing Address - City:WELLS
Mailing Address - State:ME
Mailing Address - Zip Code:04090-6614
Mailing Address - Country:US
Mailing Address - Phone:207-251-1059
Mailing Address - Fax:
Practice Address - Street 1:11 MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-7005
Practice Address - Country:US
Practice Address - Phone:207-251-1059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-02
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC6053101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional