Provider Demographics
NPI:1487021192
Name:MALONE, LESHA (LPC-CR)
Entity Type:Individual
Prefix:
First Name:LESHA
Middle Name:
Last Name:MALONE
Suffix:
Gender:F
Credentials:LPC-CR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 DUBLIN RD STE 212C
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-1000
Mailing Address - Country:US
Mailing Address - Phone:614-437-9910
Mailing Address - Fax:614-453-5975
Practice Address - Street 1:1335 DUBLIN RD STE 212C
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-1000
Practice Address - Country:US
Practice Address - Phone:614-437-9910
Practice Address - Fax:614-453-5975
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC1300613101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health