Provider Demographics
NPI:1124192117
Name:SZYMCZAK, LEONARD F (MSW LCSW)
Entity Type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:F
Last Name:SZYMCZAK
Suffix:
Gender:M
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23705 MARINER DR
Mailing Address - Street 2:# 183
Mailing Address - City:MONARCH BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92629-4306
Mailing Address - Country:US
Mailing Address - Phone:949-443-4888
Mailing Address - Fax:
Practice Address - Street 1:23705 MARINER DR
Practice Address - Street 2:# 183
Practice Address - City:MONARCH BEACH
Practice Address - State:CA
Practice Address - Zip Code:92629-4306
Practice Address - Country:US
Practice Address - Phone:949-443-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490037261041C0700X
CALCS 237131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632058OtherBLUE CROSS BLUE SHIELD