Provider Demographics
NPI:1932456076
Name:UCHENDU, LEONARD O (LLMSW)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:O
Last Name:UCHENDU
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 EOLA ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507-3429
Mailing Address - Country:US
Mailing Address - Phone:616-241-5880
Mailing Address - Fax:
Practice Address - Street 1:251 EOLA ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49507-3429
Practice Address - Country:US
Practice Address - Phone:616-241-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010946351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical