Provider Demographics
NPI:1457433112
Name:LEON, BEVERLY ALISON (MA, LPC, LSW, ALPS)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:ALISON
Last Name:LEON
Suffix:
Gender:F
Credentials:MA, LPC, LSW, ALPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1553 STEWARTSTOWN RD
Mailing Address - Street 2:APO COUNSELING
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-2947
Mailing Address - Country:US
Mailing Address - Phone:304-284-8438
Mailing Address - Fax:304-284-8486
Practice Address - Street 1:1553 STEWARTSTOWN RD
Practice Address - Street 2:APO COUNSELING
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-2947
Practice Address - Country:US
Practice Address - Phone:304-284-8438
Practice Address - Fax:304-284-8486
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV459101YP2500X
WVAPO0080099104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker