Provider Demographics
NPI:1750682316
Name:STAN LELEK P.C.
Entity Type:Organization
Organization Name:STAN LELEK P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:LELEK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:219-733-2344
Mailing Address - Street 1:8 MORGAN BLVD
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-4836
Mailing Address - Country:US
Mailing Address - Phone:219-733-2344
Mailing Address - Fax:219-733-2344
Practice Address - Street 1:8 MORGAN BLVD
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-4836
Practice Address - Country:US
Practice Address - Phone:219-733-2344
Practice Address - Fax:219-733-2344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040005251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health