Provider Demographics
NPI:1467812628
Name:LEONIS MARIE PERONE
Entity Type:Organization
Organization Name:LEONIS MARIE PERONE
Other - Org Name:BLUE BELL COUNSELING ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER,THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LEONIS
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PERONE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:610-639-1158
Mailing Address - Street 1:614 BUTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-4231
Mailing Address - Country:US
Mailing Address - Phone:610-639-1158
Mailing Address - Fax:
Practice Address - Street 1:1717 SWEDE RD STE 110
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-3372
Practice Address - Country:US
Practice Address - Phone:610-639-1158
Practice Address - Fax:610-879-2282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW012715251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health