Provider Demographics
NPI:1033463203
Name:KIYANFAR, LESLIE (LCSW)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:KIYANFAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BOURBON ST
Mailing Address - Street 2:STE 284
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70116-2708
Mailing Address - Country:US
Mailing Address - Phone:985-688-5386
Mailing Address - Fax:
Practice Address - Street 1:701 PAPWORTH AVE
Practice Address - Street 2:STE 208
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4923
Practice Address - Country:US
Practice Address - Phone:985-688-5386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA72331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical