Provider Demographics
NPI:1376138529
Name:LEAZER, MATTHEW STYLES (LCMHC-A)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:STYLES
Last Name:LEAZER
Suffix:
Gender:M
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 TUNNEL ROAD, SUITE D
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-4504
Mailing Address - Country:US
Mailing Address - Phone:828-460-1541
Mailing Address - Fax:
Practice Address - Street 1:119 TUNNEL ROAD, SUITE D
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805
Practice Address - Country:US
Practice Address - Phone:828-350-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16394101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health