Provider Demographics
NPI:1083729388
Name:LEONARD, BEVERLY A (MS, LMHC)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:A
Last Name:LEONARD
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:ANN
Other - Last Name:RIZZO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:5101 E US HIGHWAY 36
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-6645
Mailing Address - Country:US
Mailing Address - Phone:888-714-1927
Mailing Address - Fax:317-272-0807
Practice Address - Street 1:701 N ENGLEWOOD DR
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-9744
Practice Address - Country:US
Practice Address - Phone:888-714-1927
Practice Address - Fax:765-361-0374
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
PAPC004189101YP2500X
IN39002998A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional