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NPI Code Detail

MEDICARE: LESLIE MARCUS LCSW

MEDICARE: LESLIE MARCUS 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 Worker149.031443IL

General Provider Information

NPI Number : 1720934300
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE MARCUS LCSW
Provider Business Mailing Address
First Line : 1724 MOLE AVE
Second Line :
City : JANESVILLE
State : WI
Zip : 53548-1533
Country : US
Telephone Number : 815-540-9709
Fax Number :
Provider Business Practice Location Address
First Line : 1601 UNIVERSITY DR
Second Line :
City : ROCKFORD
State : IL
Zip : 61107-5317
Country : US
Telephone Number : 815-387-2521
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2026
Last Update Date : 03/06/2026

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Directions to “ LESLIE MARCUS LCSW” Practice Location

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