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NPI Code Detail

MEDICARE: LESLIE BORLAND CULBERTSON LCSW CSAC LSATP

MEDICARE:   LESLIE BORLAND CULBERTSON  LCSW CSAC LSATP
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 Worker0904003987VA

General Provider Information

NPI Number : 1841227345
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE BORLAND CULBERTSON LCSW CSAC LSATP
Provider Business Mailing Address
First Line : 2328 BAYVILLE ROAD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23455
Country : US
Telephone Number : 757-460-9857
Fax Number :
Provider Business Practice Location Address
First Line : 3755 EAST VIRGINIA BEACH BLVD
Second Line : NORFOLK COMMUNITY SERVICES BOARD
City : NORFOLK
State : VA
Zip : 23502-3238
Country : US
Telephone Number : 757-664-7699
Fax Number : 757-664-7698
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2006
Last Update Date : 07/08/2007

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Directions to “ LESLIE BORLAND CULBERTSON LCSW CSAC LSATP” Practice Location

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