Provider Demographics
NPI:1033367008
Name:LEANO-SELLERS, CYNTHIA (MED, LICDC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:LEANO-SELLERS
Suffix:
Gender:F
Credentials:MED, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2639 WOOSTER RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-2911
Mailing Address - Country:US
Mailing Address - Phone:440-895-0366
Mailing Address - Fax:440-331-2692
Practice Address - Street 1:2639 WOOSTER RD
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-2911
Practice Address - Country:US
Practice Address - Phone:440-895-0366
Practice Address - Fax:440-331-2692
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH991661101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)