Provider Demographics
NPI:1346929494
Name:MARSEGLIA, LESLIE (LMSW)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:MARSEGLIA
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 1:2450 29TH ST APT 3B
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-1630
Mailing Address - Country:US
Mailing Address - Phone:917-941-4517
Mailing Address - Fax:
Practice Address - Street 1:2450 29TH ST APT 3B
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-1630
Practice Address - Country:US
Practice Address - Phone:917-941-4517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY114191-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker