Provider Demographics
NPI:1548423353
Name:LEONI, DEBBIE (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:
Last Name:LEONI
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 RAMONA LN
Mailing Address - Street 2:
Mailing Address - City:WOOLWICH TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-4071
Mailing Address - Country:US
Mailing Address - Phone:856-467-4961
Mailing Address - Fax:856-467-4961
Practice Address - Street 1:139 RAMONA LN
Practice Address - Street 2:
Practice Address - City:WOOLWICH TWP
Practice Address - State:NJ
Practice Address - Zip Code:08085-4071
Practice Address - Country:US
Practice Address - Phone:856-467-4961
Practice Address - Fax:856-467-4961
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00364500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0162388Medicaid