Provider Demographics
NPI:1235299173
Name:TOWNSEND CRONIN, LESLEA (LCSW)
Entity Type:Individual
Prefix:
First Name:LESLEA
Middle Name:
Last Name:TOWNSEND CRONIN
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 1:1117 ABBEYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4401
Mailing Address - Country:US
Mailing Address - Phone:502-523-6122
Mailing Address - Fax:
Practice Address - Street 1:161 CHENOWETH LN STE 3
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-2653
Practice Address - Country:US
Practice Address - Phone:502-523-6122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005578A1041C0700X
KY1041S0200X
KYKY-31811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool