Provider Demographics
NPI:1144803222
Name:PORAMBO, LESLIE H (LPC)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:H
Last Name:PORAMBO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 SPRING MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-5002
Mailing Address - Country:US
Mailing Address - Phone:267-377-9152
Mailing Address - Fax:
Practice Address - Street 1:402 N FULTON ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-2002
Practice Address - Country:US
Practice Address - Phone:484-326-5955
Practice Address - Fax:610-433-4067
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013272101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional