Provider Demographics
NPI:1417707050
Name:MCSWEEN, LESLIE (LLMSW)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:
Last Name:MCSWEEN
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20239 ROSELAND ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-5459
Mailing Address - Country:US
Mailing Address - Phone:313-701-4986
Mailing Address - Fax:
Practice Address - Street 1:711 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-1873
Practice Address - Country:US
Practice Address - Phone:248-298-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851115342104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker