Provider Demographics
NPI:1093726135
Name:LEONE, LUCILA L (LMHC)
Entity Type:Individual
Prefix:
First Name:LUCILA
Middle Name:L
Last Name:LEONE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:LUCILA
Other - Middle Name:L
Other - Last Name:LEONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:335 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-1803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:335 BROADWAY
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1803
Practice Address - Country:US
Practice Address - Phone:617-671-8152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5603101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0300010Medicaid
MA1300709Medicaid
MA042485308OtherNETWORK HEALTH-GROUP
MA56049OtherFALLON SELECT
MA99622101OtherNETWORK HEALTH
MA1001250OtherBEACON-GROUP
MA221804Medicare ID - Type UnspecifiedPART A-GROUP
MAY10141Medicare ID - Type UnspecifiedPART B-GROUP
MAY10141Medicare ID - Type UnspecifiedPART B
MA042485308OtherNETWORK HEALTH-GROUP
MA1300709Medicaid