Provider Demographics
NPI:1306181326
Name:LEONARD, BERNICE A (LPC)
Entity Type:Individual
Prefix:MRS
First Name:BERNICE
Middle Name:A
Last Name:LEONARD
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 1:847 N MAIN ST
Mailing Address - Street 2:PARKSIDE COMMONS
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2668
Mailing Address - Country:US
Mailing Address - Phone:814-807-0861
Mailing Address - Fax:814-807-0863
Practice Address - Street 1:847 N MAIN ST
Practice Address - Street 2:PARKSIDE COMMONS
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-2668
Practice Address - Country:US
Practice Address - Phone:814-807-0861
Practice Address - Fax:814-807-0863
Is Sole Proprietor?:No
Enumeration Date:2012-12-02
Last Update Date:2012-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000535101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional