Healthcare Provider Details

I. General information

NPI: 1124101837
Provider Name (Legal Business Name): LESLIE HILLEARY LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 03/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 FOREST GLEN RD
SILVER SPRING MD
20910-1483
US

IV. Provider business mailing address

PO BOX 17112
BALTIMORE MD
21297-1112
US

V. Phone/Fax

Practice location:
  • Phone: 301-754-7000
  • Fax:
Mailing address:
  • Phone: 443-274-2822
  • Fax: 443-274-2391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: