Provider Demographics
NPI:1841424314
Name:MASTOROVICH, LEIGH ANN (LPC, CAADC, CCDP-D)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANN
Last Name:MASTOROVICH
Suffix:
Gender:F
Credentials:LPC, CAADC, CCDP-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 WESTMORELAND AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-3433
Mailing Address - Country:US
Mailing Address - Phone:724-216-8490
Mailing Address - Fax:724-834-1305
Practice Address - Street 1:ONE NORTHGATE SQUARE
Practice Address - Street 2:SUITE 214
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1373
Practice Address - Country:US
Practice Address - Phone:724-216-8490
Practice Address - Fax:724-420-5956
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004666101YP2500X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)