Provider Demographics
NPI:1316229255
Name:LEONOR, GIOVANNI A (LLCSW)
Entity Type:Individual
Prefix:MR
First Name:GIOVANNI
Middle Name:A
Last Name:LEONOR
Suffix:
Gender:M
Credentials:LLCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8306 N HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:BERRIEN SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49103-9503
Mailing Address - Country:US
Mailing Address - Phone:866-571-7272
Mailing Address - Fax:866-338-7272
Practice Address - Street 1:8306 N HILLCREST DR
Practice Address - Street 2:
Practice Address - City:BERRIEN SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49103-9503
Practice Address - Country:US
Practice Address - Phone:866-571-7272
Practice Address - Fax:866-338-7272
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010917401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical