Provider Demographics
NPI:1427340538
Name:JUSME, LEONARD (MA, LMHC)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:JUSME
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 BURNCOAT ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2169
Mailing Address - Country:US
Mailing Address - Phone:617-835-2976
Mailing Address - Fax:
Practice Address - Street 1:227 BURNCOAT ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606-2169
Practice Address - Country:US
Practice Address - Phone:617-835-2976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-08
Last Update Date:2015-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8839101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health