Provider Demographics
NPI:1528371036
Name:LEADER, CHARLES E (LPC)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:E
Last Name:LEADER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2227 OLD EMMORTON RD
Mailing Address - Street 2:SUITE 119
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6187
Mailing Address - Country:US
Mailing Address - Phone:410-569-9497
Mailing Address - Fax:410-569-0094
Practice Address - Street 1:1655 MANHEIM PIKE
Practice Address - Street 2:SUITE OB2
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3061
Practice Address - Country:US
Practice Address - Phone:717-945-7570
Practice Address - Fax:410-569-0094
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002710101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional