Provider Demographics
NPI:1033862453
Name:MCLAIN, LEAH
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:MCLAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 W KANAWHA AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1434
Mailing Address - Country:US
Mailing Address - Phone:614-668-9447
Mailing Address - Fax:
Practice Address - Street 1:540 OFFICENTER PL STE 180
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-5321
Practice Address - Country:US
Practice Address - Phone:888-336-1772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.19017581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical