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NPI Code Detail

MEDICARE: MRS. LESLIE ANN MAGOWN LCSW

MEDICARE: MRS. LESLIE ANN MAGOWN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker009080CT

General Provider Information

NPI Number : 1093175028
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LESLIE ANN MAGOWN LCSW
Provider Business Mailing Address
First Line : 101 SOUTH ST
Second Line :
City : WEST HARTFORD
State : CT
Zip : 06110-1967
Country : US
Telephone Number : 860-578-1300
Fax Number :
Provider Business Practice Location Address
First Line : 101 SOUTH ST
Second Line :
City : WEST HARTFORD
State : CT
Zip : 06110-1967
Country : US
Telephone Number : 860-578-1300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2016
Last Update Date : 03/07/2023

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