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NPI Code Detail

MEDICARE: MS. LESLIE DENISE LCSW

MEDICARE:  MS. LESLIE  DENISE  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 WorkerC9347MS

General Provider Information

NPI Number : 1790727378
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LESLIE DENISE LCSW
Provider Business Mailing Address
First Line : 303 HIGHWAY 90
Second Line :
City : BAY SAINT LOUIS
State : MS
Zip : 39520-2832
Country : US
Telephone Number : 228-471-3141
Fax Number :
Provider Business Practice Location Address
First Line : 303 HIGHWAY 90
Second Line :
City : BAY SAINT LOUIS
State : MS
Zip : 39520-2832
Country : US
Telephone Number : 228-471-3141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2006
Last Update Date : 07/29/2024

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Directions to “ MS. LESLIE DENISE LCSW” Practice Location

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