Provider Demographics
NPI:1609405943
Name:LEADING BY EXAMPLE LLC
Entity Type:Organization
Organization Name:LEADING BY EXAMPLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNIE
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:FIELDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-780-2692
Mailing Address - Street 1:5026 CAMPBELL BLVD STE H
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-5051
Mailing Address - Country:US
Mailing Address - Phone:410-780-2692
Mailing Address - Fax:410-480-2694
Practice Address - Street 1:5026 CAMPBELL BLVD STE H
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-5051
Practice Address - Country:US
Practice Address - Phone:410-780-2692
Practice Address - Fax:410-480-2694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management