Provider Demographics
NPI:1356595912
Name:LESHNEY, LUDMELA LOLA (MFT)
Entity type:Individual
Prefix:
First Name:LUDMELA
Middle Name:LOLA
Last Name:LESHNEY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:LUDMELA
Other - Middle Name:LOLA
Other - Last Name:NOWOSCHILOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:41408 N CONGRESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-1810
Mailing Address - Country:US
Mailing Address - Phone:623-826-9237
Mailing Address - Fax:623-551-5777
Practice Address - Street 1:41408 N CONGRESSIONAL DR
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-1810
Practice Address - Country:US
Practice Address - Phone:623-826-9237
Practice Address - Fax:623-551-5777
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT10094106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist