Provider Demographics
NPI:1114100948
Name:LEONE, MICHELE (RNFA, LMHC)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:
Last Name:LEONE
Suffix:
Gender:F
Credentials:RNFA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 WASHINGTONIA DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32934-7838
Mailing Address - Country:US
Mailing Address - Phone:321-213-9538
Mailing Address - Fax:
Practice Address - Street 1:2850 WASHINGTONIA DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32934-7838
Practice Address - Country:US
Practice Address - Phone:321-213-9538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-16
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL1751612163WR0006X
FLMH12277101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty