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NPI Code Detail

MEDICARE: MRS. KRISTI JO MCLEISH LICDC

MEDICARE:  MRS. KRISTI JO MCLEISH  LICDC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor164220OH

General Provider Information

NPI Number : 1548829864
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTI JO MCLEISH LICDC
Provider Business Mailing Address
First Line : 250 ZION RIDGE RD
Second Line :
City : MARIETTA
State : OH
Zip : 45750-7776
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 151 S KENNEBEC AVE
Second Line :
City : MCCONNELSVILLE
State : OH
Zip : 43756-1211
Country : US
Telephone Number : 740-960-0568
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2019
Last Update Date : 09/18/2024

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Directions to “ MRS. KRISTI JO MCLEISH LICDC” Practice Location

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