Healthcare Provider Details

I. General information

NPI: 1508991183
Provider Name (Legal Business Name): MARGARET LEISTER CADC, LCDP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 S GOVERNORS AVE
DOVER DE
19904-7020
US

IV. Provider business mailing address

1550 S GOVERNORS AVE
DOVER DE
19904-7020
US

V. Phone/Fax

Practice location:
  • Phone: 302-678-4558
  • Fax: 302-678-4577
Mailing address:
  • Phone: 302-678-4558
  • Fax: 302-678-4577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number794
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCD0000026
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: