MEDICARE: DR. LESLIE R. ABRAMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	3924	MA

General Provider Information

NPI Number	:	1386737344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLIE R. ABRAMS

Provider Business Mailing Address
First Line	:	21 LEAD MINE RD
Second Line	:
City	:	LEVERETT
State	:	MA
Zip	:	01054-9524
Country	:	US
Telephone Number	:	413-548-8032
Fax Number	:

Provider Business Practice Location Address
First Line	:	235 GREENFIELD RD
Second Line	:
City	:	SOUTH DEERFIELD
State	:	MA
Zip	:	01373-9753
Country	:	US
Telephone Number	:	413-665-2110
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	08/17/2009

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