Healthcare Provider Details

I. General information

NPI: 1124273123
Provider Name (Legal Business Name): LESLIE J. PALUMBERI, LCSW, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2008
Last Update Date: 12/03/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 PANTHER LANE SUITE 203
NAPLES FL
34109-7874
US

IV. Provider business mailing address

1415 PANTHER LANE SUITE 203
NAPLES FL
34109-7874
US

V. Phone/Fax

Practice location:
  • Phone: 239-777-4843
  • Fax: 239-591-6601
Mailing address:
  • Phone: 239-777-4843
  • Fax: 239-591-6601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LESLIEJ PALUMBERI
Title or Position: PSYCHOTHERAPIST
Credential: LCSW
Phone: 239-591-6636