Provider Demographics
NPI:1487392155
Name:LECKNER, HAYLEY (MA, BCBA)
Entity type:Individual
Prefix:MISS
First Name:HAYLEY
Middle Name:
Last Name:LECKNER
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12941 W 151ST AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR LAKE
Mailing Address - State:IN
Mailing Address - Zip Code:46303-9045
Mailing Address - Country:US
Mailing Address - Phone:219-741-6239
Mailing Address - Fax:
Practice Address - Street 1:8438 INDIANA ST
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6357
Practice Address - Country:US
Practice Address - Phone:219-525-4572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-21-51631103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst