Provider Demographics
NPI:1548627433
Name:LEADING BY EXAMPLE LLC.
Entity type:Organization
Organization Name:LEADING BY EXAMPLE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNNIE
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:FIELDING
Authorized Official - Suffix:JR
Authorized Official - Credentials:MSW
Authorized Official - Phone:443-957-5237
Mailing Address - Street 1:5026 CAMPBELL BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4966
Mailing Address - Country:US
Mailing Address - Phone:410-780-2692
Mailing Address - Fax:410-780-2694
Practice Address - Street 1:5026 CAMPBELL BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-4966
Practice Address - Country:US
Practice Address - Phone:410-780-2692
Practice Address - Fax:410-780-2694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1623251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health