Provider Demographics
NPI:1255985651
Name:LEB, JULIA ARIEL (LCP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ARIEL
Last Name:LEB
Suffix:
Gender:F
Credentials:LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2475 CHANNING RD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-4458
Mailing Address - Country:US
Mailing Address - Phone:330-888-3144
Mailing Address - Fax:
Practice Address - Street 1:23425 COMMERCE PARK STE 104
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5848
Practice Address - Country:US
Practice Address - Phone:330-888-3144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1500604101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health