Provider Demographics
NPI:1164005815
Name:GINN, LEON (MSPC)
Entity type:Individual
Prefix:
First Name:LEON
Middle Name:
Last Name:GINN
Suffix:
Gender:M
Credentials:MSPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 FARRAGUT ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-2201
Mailing Address - Country:US
Mailing Address - Phone:215-499-2242
Mailing Address - Fax:
Practice Address - Street 1:520 BROOKLINE BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15226-2002
Practice Address - Country:US
Practice Address - Phone:412-216-0018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health