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NPI Code Detail

MEDICARE: STAN LELEK P.C.

MEDICARE: STAN LELEK P.C.
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
1251S00000XCommunity/Behavioral Health Agency20040005IN

General Provider Information

NPI Number : 1750682316
Entity Type Code : Organization
Provider Name (Legal Business Name) : STAN LELEK P.C.
Provider Business Mailing Address
First Line : 8 MORGAN BLVD
Second Line :
City : VALPARAISO
State : IN
Zip : 46383-4836
Country : US
Telephone Number : 219-733-2344
Fax Number : 219-733-2344
Provider Business Practice Location Address
First Line : 8 MORGAN BLVD
Second Line :
City : VALPARAISO
State : IN
Zip : 46383-4836
Country : US
Telephone Number : 219-733-2344
Fax Number : 219-733-2344
Authorized Official
Title or Position : PSYCHOLOGIST/PRESIDENT
Name : DR. STAN P LELEK
Credential : PSY.D.
Telephone Number : 219-733-2344
Provider Enumeration Date : 11/12/2010
Last Update Date : 11/12/2010

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