Provider Demographics
NPI:1306218847
Name:PERELMUTTER, LEEAT (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:LEEAT
Middle Name:
Last Name:PERELMUTTER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2847 34TH ST
Mailing Address - Street 2:APT 17
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-5072
Mailing Address - Country:US
Mailing Address - Phone:773-807-1333
Mailing Address - Fax:
Practice Address - Street 1:2847 34 STREET
Practice Address - Street 2:APT 17
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103
Practice Address - Country:US
Practice Address - Phone:773-807-1333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088444-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical