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General NPI Number Information
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NPI Number | 1700990884
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Entity Type | Individual
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Provider Name | DONALD A LEAKE BA MA LSW
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Gender | Male
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3690 ORANGE PL SUITE 220
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City | BEACHWOOD
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State | OH
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Zip | 44122-4464
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Country | US
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Telephone | 216-831-1494
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Fax |
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Provider Business Mailing Address
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Address Line | 153 E MAIN ST
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City | NORWALK
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State | OH
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Zip | 44857-1899
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Country | US
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Telephone | 419-668-7628
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1041C0700X 5.0031124
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 1041C0700X 5.0031124
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 1041C0700X 5.0031124
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1041C0700X 5.0031124
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | 1041C0700X 5.0031124
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License Number State | OH
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1041C0700X 5.0031124
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License Number State | OH
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