Provider Demographics
NPI:1174678486
Name:STERNBERG, LESLIE E (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:E
Last Name:STERNBERG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:789 E PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1595
Mailing Address - Country:US
Mailing Address - Phone:413-549-0232
Mailing Address - Fax:
Practice Address - Street 1:789 E PLEASANT ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-1595
Practice Address - Country:US
Practice Address - Phone:413-549-0232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4510103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAR43344Medicare UPIN
MAWW0270Medicare ID - Type Unspecified