Provider Demographics
NPI:1366814352
Name:LESKO, MICHAEL (MSW, LISW, CDCA)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:LESKO
Suffix:
Gender:M
Credentials:MSW, LISW, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8880 COX RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069
Mailing Address - Country:US
Mailing Address - Phone:513-486-4576
Mailing Address - Fax:513-672-1002
Practice Address - Street 1:8880 COX RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-3330
Practice Address - Country:US
Practice Address - Phone:513-486-4576
Practice Address - Fax:513-672-1002
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.17004981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0238358Medicaid