Provider Demographics
NPI:1083823207
Name:JEVNIKAR, LESLIE JEAN (LPCC,LSW)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:JEAN
Last Name:JEVNIKAR
Suffix:
Gender:F
Credentials:LPCC,LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6221 MAYPINE FARM BLVD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-4508
Mailing Address - Country:US
Mailing Address - Phone:440-442-9613
Mailing Address - Fax:
Practice Address - Street 1:8401 CHAGRIN RD
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-4701
Practice Address - Country:US
Practice Address - Phone:440-543-3400
Practice Address - Fax:440-543-2287
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE 0002575101YP2500X
OHS 0017109104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker