Provider Demographics
NPI:1083074892
Name:LEKAN, CASSIDY (LCSW, LISW)
Entity Type:Individual
Prefix:
First Name:CASSIDY
Middle Name:
Last Name:LEKAN
Suffix:
Gender:F
Credentials:LCSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-3361
Mailing Address - Country:US
Mailing Address - Phone:859-392-3304
Mailing Address - Fax:
Practice Address - Street 1:313 MADISON PIKE
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41017-9413
Practice Address - Country:US
Practice Address - Phone:859-491-4435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-07
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1303250.SUPV104100000X, 1041C0700X
OH131094101YA0400X
KY50871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0437602Medicaid
KY7100346650Medicaid