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NPI Code Detail

MEDICARE: LESLIE WARTGOW LPCC

MEDICARE: LESLIE WARTGOW LPCC
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
1101YP2500XProfessional CounselorE0600074OH

General Provider Information

NPI Number : 1801180344
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE WARTGOW LPCC
Provider Business Mailing Address
First Line : 2202 PRAME AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-1626
Country : US
Telephone Number : 216-651-0360
Fax Number : 216-651-6491
Provider Business Practice Location Address
First Line : 11401 LORAIN AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-5428
Country : US
Telephone Number : 216-651-0360
Fax Number : 216-651-6491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2011
Last Update Date : 06/01/2011

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