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Provider Information for 1588116925


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ALICIA MARIE LEITWEIN LCDC II


Sex: Female

NPI: 1588116925
Last Updated: 2025-03-07
Certification Date: 2025-03-07

Details

NameValue
NPI1588116925
Enumeration Date2016-11-02
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 4490 SITTERLY RD
CANAL WINCHESTER, OH 43110-8870
United States

Phone: 614-315-6297 | Fax:
 
Primary Practice Address 131 W MAIN ST
LANCASTER, OH 43130-3719
United States

Phone: 614-746-8725 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YA0400X - Counselor - Addiction (Substance Use Disorder)OH161131
Yes 1041C0700X - Social Worker - Clinical