Provider Demographics
NPI:1306377304
Name:LEMAN, CHARLA (LCSW)
Entity Type:Individual
Prefix:
First Name:CHARLA
Middle Name:
Last Name:LEMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8011 BASSWOOD PL
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46835-4752
Mailing Address - Country:US
Mailing Address - Phone:740-213-1932
Mailing Address - Fax:
Practice Address - Street 1:8011 BASSWOOD PL
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46835-4752
Practice Address - Country:US
Practice Address - Phone:740-213-1932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006143A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical