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General NPI Number Information
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NPI Number | 1316474844
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Entity Type | Individual
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Provider Name | CHRISTOPHER LEONARD MSW, LICSW, LCSW
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Gender | Male
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Dates
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Enumeration Date | 05/15/2017
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 6 MILL ST
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City | MIDDLEBURY
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State | VT
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Zip | 05753-1132
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Country | US
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Telephone | 201-723-6995
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Fax |
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Provider Business Mailing Address
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Address Line | 10 MAIN ST UNIT 208
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City | MIDDLEBURY
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State | VT
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Zip | 05753-7408
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Country | US
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Telephone | 201-723-6995
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 096414
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License Number State | NY
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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 | 44SCO4556500
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License Number State | NJ
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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 | 089.0134364
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License Number State | VT
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