Provider Demographics
NPI:1154661486
Name:CITRON, LEONARD (MA LMHC)
Entity Type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:
Last Name:CITRON
Suffix:
Gender:M
Credentials:MA LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 W 18TH ST
Mailing Address - Street 2:APARTMENT 6E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-4422
Mailing Address - Country:US
Mailing Address - Phone:917-587-7666
Mailing Address - Fax:
Practice Address - Street 1:322 8TH AVE
Practice Address - Street 2:SUITE 802
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-8001
Practice Address - Country:US
Practice Address - Phone:917-587-7666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-23
Last Update Date:2013-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005414-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health