Provider Demographics
NPI:1164987475
Name:HOWARD, LEON JR (DAR)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:
Last Name:HOWARD
Suffix:JR
Gender:M
Credentials:DAR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 PINEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-2041
Mailing Address - Country:US
Mailing Address - Phone:609-706-1627
Mailing Address - Fax:
Practice Address - Street 1:30 PINEWOOD LN
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-2041
Practice Address - Country:US
Practice Address - Phone:609-706-1627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH68724596208702Medicaid