Provider Demographics
NPI:1174984223
Name:MCNAMARA, LESLIE (LPCC-S)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35900 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4623
Mailing Address - Country:US
Mailing Address - Phone:440-953-3000
Mailing Address - Fax:440-953-3274
Practice Address - Street 1:35900 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4623
Practice Address - Country:US
Practice Address - Phone:440-953-3000
Practice Address - Fax:440-953-3274
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1300004-SUPV101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health