Provider Demographics
NPI:1134487382
Name:BAUER, LESA C (LPCC-S)
Entity type:Individual
Prefix:
First Name:LESA
Middle Name:C
Last Name:BAUER
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11330 CLEVELAND AVE NW
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-8078
Mailing Address - Country:US
Mailing Address - Phone:330-595-9059
Mailing Address - Fax:330-595-1525
Practice Address - Street 1:11330 CLEVELAND AVE NW
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-8078
Practice Address - Country:US
Practice Address - Phone:330-595-9059
Practice Address - Fax:330-595-1525
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0900661-SUPV101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0214802Medicaid
13864077OtherCAQH