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General NPI Number Information
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NPI Number | 1467787796
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Entity Type | Individual
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Provider Name | LEAH KAFENBAUM LEICHT PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 10/05/2009
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Last Update Date | 12/27/2011
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Provider Practice Location Address
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Address Line | 641 PRESIDENT ST SUITE 101
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City | BROOKLYN
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State | NY
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Zip | 11215-1523
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Country | US
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Telephone | 718-635-1525
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Fax |
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Provider Business Mailing Address
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Address Line | 25 BERGEN ST 2B
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City | BROOKLYN
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State | NY
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Zip | 11201-8620
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Country | US
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Telephone | 917-855-7741
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 68018864
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License Number State | NY
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