Provider Demographics
NPI:1013209014
Name:MENA, LEIDY MAGDALENA (LCMFT)
Entity Type:Individual
Prefix:MISS
First Name:LEIDY
Middle Name:MAGDALENA
Last Name:MENA
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8720 GEORGIA AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3638
Mailing Address - Country:US
Mailing Address - Phone:240-899-2666
Mailing Address - Fax:
Practice Address - Street 1:8720 GEORGIA AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3638
Practice Address - Country:US
Practice Address - Phone:240-899-2666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM432106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist