Provider Demographics
NPI:1124188107
Name:SCHMALTZ, LESLEY ELLEN (LSW, CSW)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:ELLEN
Last Name:SCHMALTZ
Suffix:
Gender:F
Credentials:LSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2818 GRANT LINE RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-2492
Mailing Address - Country:US
Mailing Address - Phone:812-944-6120
Mailing Address - Fax:812-941-5726
Practice Address - Street 1:2818 GRANT LINE RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-2492
Practice Address - Country:US
Practice Address - Phone:812-944-6120
Practice Address - Fax:812-941-5726
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY50861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical