Healthcare Provider Details

I. General information

NPI: 1396069241
Provider Name (Legal Business Name): KATHERINE L LECKEL MS, LPCMH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2010
Last Update Date: 10/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E 12TH ST
WILMINGTON DE
19801-3403
US

IV. Provider business mailing address

401 E 12TH ST
WILMINGTON DE
19801-3403
US

V. Phone/Fax

Practice location:
  • Phone: 302-576-8080
  • Fax: 302-576-8084
Mailing address:
  • Phone: 392-576-8080
  • Fax: 302-576-8084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC-0000486
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: