Provider Demographics
NPI:1003172453
Name:LEON, DAMARY (LMHC)
Entity Type:Individual
Prefix:
First Name:DAMARY
Middle Name:
Last Name:LEON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7969 NW 2ND ST STE 323
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-8018
Mailing Address - Country:US
Mailing Address - Phone:305-490-7178
Mailing Address - Fax:
Practice Address - Street 1:13028 SW 120TH ST # 9
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4522
Practice Address - Country:US
Practice Address - Phone:305-490-7178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017511000Medicaid