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General NPI Number Information
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NPI Number | 1467532291
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Entity Type | Individual
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Provider Name | LESLEY C SAMUEL-YOUNG L.M.S.W.
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Gender | Female
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 20-02 SEAGIRT BLVD JBFCS TRANSITION CENTER
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City | FAR ROCKAWAY, QUEENS
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State | NY
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Zip | 11691
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Country | US
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Telephone | 718-520-8045
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Fax | 718-327-4230
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Provider Business Mailing Address
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Address Line | 2420 GLENWOOD RD #2A
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City | BROOKLYN
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State | NY
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Zip | 11210-1150
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Country | US
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Telephone | 718-859-0393
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 055198-1
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License Number State | NY
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