Provider Demographics
NPI:1063615540
Name:KENOWITZ, LEONARD ALAN (PHD,LADC)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:ALAN
Last Name:KENOWITZ
Suffix:
Gender:M
Credentials:PHD,LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 WAYFARING RD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-1824
Mailing Address - Country:US
Mailing Address - Phone:203-847-4094
Mailing Address - Fax:
Practice Address - Street 1:71 EAST AVE
Practice Address - Street 2:SUITE R
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-4903
Practice Address - Country:US
Practice Address - Phone:203-831-9385
Practice Address - Fax:203-866-1509
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT171101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)