Provider Demographics
NPI:1760521108
Name:LEONE, DEAN ROGER (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:ROGER
Last Name:LEONE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-3809
Mailing Address - Country:US
Mailing Address - Phone:203-314-6794
Mailing Address - Fax:860-262-5477
Practice Address - Street 1:495 ORANGE ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3809
Practice Address - Country:US
Practice Address - Phone:203-314-6794
Practice Address - Fax:860-262-5477
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002089103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist