Provider Demographics
NPI:1225690035
Name:OSPINA, LEONAR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:LEONAR
Middle Name:
Last Name:OSPINA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 67TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-3709
Mailing Address - Country:US
Mailing Address - Phone:201-289-2390
Mailing Address - Fax:
Practice Address - Street 1:1201 67TH ST APT 2
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-3709
Practice Address - Country:US
Practice Address - Phone:201-289-2390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058618001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical