Provider Demographics
NPI:1760593321
Name:LEEKS, JOHN (LICDC, SAP, CADC II)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:LEEKS
Suffix:
Gender:M
Credentials:LICDC, SAP, CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3214 PROSPECT AVE E
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-2614
Mailing Address - Country:US
Mailing Address - Phone:216-910-9015
Mailing Address - Fax:
Practice Address - Street 1:3214 PROSPECT AVE E
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-2614
Practice Address - Country:US
Practice Address - Phone:216-910-9015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH83950101YA0400X
CARA854007101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)