Provider Demographics
NPI:1518070168
Name:LEON, LINDA VASANT (PHD, MSW)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:VASANT
Last Name:LEON
Suffix:
Gender:F
Credentials:PHD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 41
Mailing Address - Street 2:BOX 2398
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09464
Mailing Address - Country:GB
Mailing Address - Phone:0114-416-3852
Mailing Address - Fax:
Practice Address - Street 1:UNIT 5210
Practice Address - Street 2:BOX 230
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09461
Practice Address - Country:GB
Practice Address - Phone:01144163-852-8124
Practice Address - Fax:226-8022
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILC-4436101YA0400X
OHI 00089531041C0700X
NCA0004171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical