Provider Demographics
NPI:1447028899
Name:LEADEM COUNSELING
Entity type:Organization
Organization Name:LEADEM COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEADEM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-848-4507
Mailing Address - Street 1:1007 INLAND RD
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-5209
Mailing Address - Country:US
Mailing Address - Phone:609-848-4507
Mailing Address - Fax:
Practice Address - Street 1:668 COMMONS WAY BLDG I
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6431
Practice Address - Country:US
Practice Address - Phone:732-797-1444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty