Provider Demographics
NPI:1477642593
Name:KAJS, LEONARD R (LCSW)
Entity type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:R
Last Name:KAJS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:LEONARD
Other - Middle Name:R
Other - Last Name:KAJS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW L P C SAP
Mailing Address - Street 1:8207 CALLAGHAN RD STE 425
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4737
Mailing Address - Country:US
Mailing Address - Phone:210-979-7100
Mailing Address - Fax:210-979-7909
Practice Address - Street 1:8207 CALLAGHAN RD STE 425
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4737
Practice Address - Country:US
Practice Address - Phone:210-979-7100
Practice Address - Fax:210-979-7909
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3262106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0S59EMedicare ID - Type Unspecified