Provider Demographics
NPI:1225187503
Name:HENDELMAN, LESLIE ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANN
Last Name:HENDELMAN
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 1:230 RIVERSIDE DRIVE
Mailing Address - Street 2:SUITE # 3L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6133
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 RIVERSIDE DR
Practice Address - Street 2:SUITE # 3L
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6105
Practice Address - Country:US
Practice Address - Phone:212-316-2554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0246191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical