Healthcare Provider Details

I. General information

NPI: 1609781772
Provider Name (Legal Business Name): LESLIE DIAN WILLIAMS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 LAKE ST STE 240
BURLINGTON VT
05401-5284
US

IV. Provider business mailing address

20 PHEASANT WOODS APT 201
COLCHESTER VT
05446-1887
US

V. Phone/Fax

Practice location:
  • Phone: 802-448-2189
  • Fax:
Mailing address:
  • Phone: 561-589-9771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number097.0136495
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: