Provider Demographics
NPI:1194818187
Name:LESCHT, STEPHEN ALAN (DSW LCSWC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ALAN
Last Name:LESCHT
Suffix:
Gender:M
Credentials:DSW LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:692 RITCHIE HIGHWAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146
Mailing Address - Country:US
Mailing Address - Phone:410-544-3336
Mailing Address - Fax:410-544-6725
Practice Address - Street 1:692 RITCHIE HIGHWAY
Practice Address - Street 2:SUITE 102
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146
Practice Address - Country:US
Practice Address - Phone:410-544-3336
Practice Address - Fax:410-544-6725
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01244104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
003276OtherVALUE OPTIONS
MDQ214OtherCARE FIRST
MDR5770001OtherCARE FIRST NATIONAL
DCR5770001OtherCARE FIRST NATIONAL
VAR5770001OtherCARE FIRST NATIONAL
154786OtherMANAGED HEALTH NETWORK
DCR5770001OtherCARE FIRST NATIONAL