Doctor Name: | LEONARD R PHILLIPS |
NPI Number: | 1386883882 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSW, LCSW-R |
License Number: | 018434 |
Business Practice Address: | 36 Reed St Marcellus, NY - 131081128 |
Business Phone Number: | 3156730840 |
Business Fax Number: | 3156730840 |
Mailing Address: | 36 Reed St, MARCELLUS |
State: | NY |
Postal Code: | 131081128 |
Phone Number: | 3156730840 |
Fax Number: | 3156730840 |
NPI Enumeration Date: | 02/07/2009 |
NPI Last Update Date: | 02/07/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 018434 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |