Provider Demographics
NPI:1194912691
Name:LEDET, ALAN O (LMFT)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:O
Last Name:LEDET
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 N TIOGA ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-4205
Mailing Address - Country:US
Mailing Address - Phone:607-266-8169
Mailing Address - Fax:607-257-3943
Practice Address - Street 1:319 N TIOGA ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4205
Practice Address - Country:US
Practice Address - Phone:607-266-8169
Practice Address - Fax:607-257-3943
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000465106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist