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General NPI Number Information
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NPI Number | 1518142819
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Entity Type | Individual
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Provider Name | LESLIE MICHELE PEREIRA PH.D., MSW
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Gender | Female
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Dates
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Enumeration Date | 01/04/2008
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Last Update Date | 01/04/2008
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Provider Practice Location Address
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Address Line | 10 MAIN ST SUITE 323
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City | NEW PALTZ
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State | NY
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Zip | 12561-1762
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Country | US
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Telephone | 917-533-3082
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Fax |
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Provider Business Mailing Address
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Address Line | 43 CORRIEDALE LN
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City | COTTEKILL
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State | NY
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Zip | 12419-5029
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Country | US
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Telephone | 917-533-3082
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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 | R065845-1
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License Number State | NY
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