Provider Demographics
NPI:1174717565
Name:LEON, ADELA LOURDES (LCPC)
Entity type:Individual
Prefix:MRS
First Name:ADELA
Middle Name:LOURDES
Last Name:LEON
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 1:502 EAST MELBOURNE AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901
Mailing Address - Country:US
Mailing Address - Phone:301-742-1556
Mailing Address - Fax:301-434-8309
Practice Address - Street 1:502 E MELBOURNE AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-2818
Practice Address - Country:US
Practice Address - Phone:301-742-1556
Practice Address - Fax:301-434-8309
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1981101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional