Provider Demographics
NPI:1255674578
Name:WELDON, LEALAR F (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LEALAR
Middle Name:F
Last Name:WELDON
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 1:145 DAVENPORT RD
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-4587
Mailing Address - Country:US
Mailing Address - Phone:267-259-8015
Mailing Address - Fax:302-653-2689
Practice Address - Street 1:5159 N 9TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141
Practice Address - Country:US
Practice Address - Phone:267-326-1427
Practice Address - Fax:215-457-3031
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006532101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional