Leon Vandyke
Individual provider Active NPI Professional Counselor · Fayette, MO
NPI 1912732207 · NPPES record last updated Sep 11, 2026
Key facts
- NPI
- 1912732207
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 2026034773 (MO)
- Practice address
- 600 W Morrison St Ste 16
Fayette, MO 65248-1075 - Phone
- (775) 997-8646
- NPI assigned
- Sep 5, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024036077 | MO | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2026034773 | MO | Yes |
Addresses
Primary practice location
600 W Morrison St Ste 16
Fayette, MO 65248-1075
Mailing address
600 W Morrison St Ste 16
Fayette, MO 65248-1075
Other providers in Fayette, MO
- Kayla Strodtman
- Ashley Marie Swon
- Hope I Tinker
- Lady Tiriat
- Julia Degorce Townsley
- Wade M Welton
- Ashley Elizabeth Wills
- Crystin Wilson
- Michael Tyler Wilson
All providers in Fayette, MO · Professional Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.