Provider Demographics
NPI:1770619215
Name:LECH, BRIAN C (PHD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:C
Last Name:LECH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26852
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89126-0852
Mailing Address - Country:US
Mailing Address - Phone:702-300-5259
Mailing Address - Fax:702-380-3220
Practice Address - Street 1:1800 INDUSTRIAL RD STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2685
Practice Address - Country:US
Practice Address - Phone:702-380-3220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPSY 0196103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVPHD196Medicare ID - Type UnspecifiedPSYCHOLOGIST