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NPI Code Detail

MEDICARE: CHARLIE ALEXANDRA LEAHEY LMSW

MEDICARE: CHARLIE ALEXANDRA LEAHEY LMSW
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
1104100000XSocial Worker10959CT

General Provider Information

NPI Number : 1689463812
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLIE ALEXANDRA LEAHEY LMSW
Provider Business Mailing Address
First Line : 17 BRIDGE SQ
Second Line :
City : WESTPORT
State : CT
Zip : 06880-5901
Country : US
Telephone Number : 475-349-2129
Fax Number :
Provider Business Practice Location Address
First Line : 17 BRIDGE SQ
Second Line :
City : WESTPORT
State : CT
Zip : 06880-5901
Country : US
Telephone Number : 475-349-2129
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2025
Last Update Date : 10/09/2025

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Directions to “ CHARLIE ALEXANDRA LEAHEY LMSW” Practice Location

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