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General NPI Number Information
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NPI Number | 1861630923
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Entity Type | Organization
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Legal Business Name | CHARLES LEIGHTON ASSOC LLC
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Dates
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Enumeration Date | 01/28/2009
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Last Update Date | 05/27/2011
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Provider Practice Location Address
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Address Line | 45 CAREY AVE SUITE 204
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City | BUTLER
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State | NJ
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Zip | 07405-1443
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Country | US
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Telephone | 973-851-5095
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Fax |
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Provider Business Mailing Address
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Address Line | 45 CAREY AVE SUITE 204
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City | BUTLER
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State | NJ
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Zip | 07405-1443
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CHARLES LEIGHTON
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Credential | LCSW,CGP
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Telephone | 973-851-5095
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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 | 045106-1
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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 | 44SC04672200
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License Number State | NJ
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