Provider Demographics
NPI:1679642581
Name:LESYK, CAROLEE KUHNS (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROLEE
Middle Name:KUHNS
Last Name:LESYK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 SUGARBUSH LANE
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-4109
Mailing Address - Country:US
Mailing Address - Phone:440-338-4816
Mailing Address - Fax:440-338-6704
Practice Address - Street 1:2460 FAIRMOUNT BLVD STE 209
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44106-3125
Practice Address - Country:US
Practice Address - Phone:216-229-4020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2276103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLECP10512Medicare ID - Type Unspecified