Provider Demographics
NPI:1093818528
Name:CLEAVER, LESLIE A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:A
Last Name:CLEAVER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:ARANOA
Other - Last Name:CLEAVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3701 N GREENVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-7078
Mailing Address - Country:US
Mailing Address - Phone:312-263-1230
Mailing Address - Fax:888-876-6566
Practice Address - Street 1:3701 N GREENVIEW AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-7078
Practice Address - Country:US
Practice Address - Phone:312-263-1230
Practice Address - Fax:888-876-6566
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490019511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0001605153OtherBLUE CROSS BLUE SHIELD
0001605153OtherBLUE CROSS PPO
208451Medicare PIN