Basic Information
| Provider Information | |||||||||
| NPI: | 1033269865 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEHR | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | MELINDA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LSW, LICDC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 391 S LINDEN RD | ||||||||
| Address2: | |||||||||
| City: | MANSFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 449067911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4197569191 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 270 STERKEL BLVD | ||||||||
| Address2: | |||||||||
| City: | MANSFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 449071508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195266168 | ||||||||
| FaxNumber: | 4195262753 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 954238 | OH | X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | S6527 | OH | X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.