Provider Demographics
NPI:1336598531
Name:ORCHINIK, LEAH JENNIE (PHD)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:JENNIE
Last Name:ORCHINIK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 191
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19723-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-4000
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:102 W. WATER STREET, SUITE 1
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-6750
Practice Address - Country:US
Practice Address - Phone:302-672-5650
Practice Address - Fax:302-672-5655
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE103TC2200X
DEB10001055103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent