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General NPI Number Information
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NPI Number | 1023357027
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Entity Type | Organization
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Legal Business Name | DR. LESLIE DONNELLY AND ASSOCIATES
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Dates
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Enumeration Date | 02/11/2013
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Last Update Date | 10/16/2014
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Provider Practice Location Address
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Address Line | 116 W MAIN ST SUITE 201
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City | SALISBURY
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State | MD
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Zip | 21801-4905
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Country | US
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Telephone | 410-742-7160
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Fax | 410-546-1048
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Provider Business Mailing Address
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Address Line | PO BOX 1627
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City | SALISBURY
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State | MD
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Zip | 21802-1627
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Country | US
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Telephone | 410-742-7160
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Fax | 410-546-1048
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. LESLIE DONNELLY
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Credential |
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Telephone | 410-742-7160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 111175
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 08692
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 03248
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License Number State | MD
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