MEDICARE: KATHLEEN A LESER 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
1	104100000X	Social Worker	CSW003213	GA

General Provider Information

NPI Number	:	1154412328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN A LESER LCSW

Provider Business Mailing Address
First Line	:	2801 BUFORD HWY NE
Second Line	:	SUITE 505
City	:	ATLANTA
State	:	GA
Zip	:	30329-2149
Country	:	US
Telephone Number	:	404-402-8590
Fax Number	:

Provider Business Practice Location Address
First Line	:	2801 BUFORD HWY NE
Second Line	:	SUITE 505
City	:	ATLANTA
State	:	GA
Zip	:	30329-2149
Country	:	US
Telephone Number	:	404-402-8590
Fax Number	:	404-315-9235

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	04/20/2011

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Directions to “ KATHLEEN A LESER LCSW” Practice Location

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