Provider Demographics
NPI:1407361082
Name:HUFF, LESLIE ANN (LSW)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANN
Last Name:HUFF
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 UTICA AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-3962
Mailing Address - Country:US
Mailing Address - Phone:216-835-4188
Mailing Address - Fax:
Practice Address - Street 1:1530 W RIVER RD N STE 300
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-2788
Practice Address - Country:US
Practice Address - Phone:216-835-4188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-05
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0028367104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker