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General NPI Number Information
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NPI Number | 1265606602
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Entity Type | Organization
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Legal Business Name | LESLIE WELLINGTON, LCSW,LTD
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 09/09/2008
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Provider Practice Location Address
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Address Line | 3330 OLD GLENVIEW RD
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City | WILMETTE
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State | IL
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Zip | 60091-2963
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Country | US
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Telephone | 847-251-1582
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Fax | 847-251-3685
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Provider Business Mailing Address
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Address Line | 3330 OLD GLENVIEW RD
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City | WILMETTE
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State | IL
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Zip | 60091-2963
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Country | US
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Telephone | 847-251-1582
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Fax | 847-251-3685
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MS. LESLIE KAPLAN WELLINGTON
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Credential | LCSW
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Telephone | 847-251-1582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149003571
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License Number State | IL
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