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General NPI Number Information
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NPI Number | 1841590460
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Entity Type | Individual
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Provider Name | SUSAN ELIZABETH LE DEAN MS LPC, LCAC
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Gender | Female
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Dates
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Enumeration Date | 10/29/2010
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 12351 W. 96TH TERR SUITE 300
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City | LENEXA
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State | KS
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Zip | 66215
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Country | US
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Telephone | 913-894-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 703 CLAYWOODS PKWY
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City | LIBERTY
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State | MO
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Zip | 64068-4343
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Country | US
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Telephone | 816-665-5910
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 252
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2152
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License Number State | KS
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