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General NPI Number Information
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NPI Number | 1548338957
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Entity Type | Individual
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Provider Name | CHARLES LEIGHTON L.C.S.W.
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Gender | Male
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 05/27/2011
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Provider Practice Location Address
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Address Line | 44 ROUTE 23 NORTH SUITE 3
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City | RIVERDALE
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State | NJ
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Zip | 07457-0003
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Country | US
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Telephone | 973-851-5095
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Fax | 973-305-5902
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Provider Business Mailing Address
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Address Line | 45 CAREY AVE. SUITE 204
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City | BUTTER
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State | NJ
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Zip | 07405
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Country | US
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Telephone | 973-527-4410
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Fax | 973-527-4409
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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 |
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License Number State |
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