Provider Demographics
NPI:1689182610
Name:DEAN LEONE DBA CORE RECOVERY, LLC
Entity type:Organization
Organization Name:DEAN LEONE DBA CORE RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:LEONE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYCHOLOGIST, PHD
Authorized Official - Phone:203-314-6794
Mailing Address - Street 1:41 CRESCENT BLUFF AVE
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-5503
Mailing Address - Country:US
Mailing Address - Phone:203-314-6794
Mailing Address - Fax:
Practice Address - Street 1:5 DURHAM RD
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2076
Practice Address - Country:US
Practice Address - Phone:203-314-6794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-11
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2089103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty