Provider Demographics
NPI:1134487382
Name:BAUER, LESA C (LPCC)
Entity Type:Individual
Prefix:
First Name:LESA
Middle Name:C
Last Name:BAUER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44303-1406
Mailing Address - Country:US
Mailing Address - Phone:330-996-4600
Mailing Address - Fax:330-564-9296
Practice Address - Street 1:611 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44303-1406
Practice Address - Country:US
Practice Address - Phone:330-996-4600
Practice Address - Fax:330-564-9296
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0900661101YP2500X
OHC 0900661101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor