Provider Demographics
NPI:1215378310
Name:LEUENBERGER, JONAS WESLEY (LMSW)
Entity Type:Individual
Prefix:MR
First Name:JONAS
Middle Name:WESLEY
Last Name:LEUENBERGER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 SW MARTIN DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66609-1217
Mailing Address - Country:US
Mailing Address - Phone:785-783-8438
Mailing Address - Fax:785-861-7174
Practice Address - Street 1:4101 SW MARTIN DR
Practice Address - Street 2:SUITE B
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66609-1217
Practice Address - Country:US
Practice Address - Phone:785-783-8438
Practice Address - Fax:785-861-7147
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS48371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical