Provider Demographics
NPI:1467498998
Name:RADEL, LESLIE A (LCSW)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:A
Last Name:RADEL
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 1:152 MADISON AVE
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5424
Mailing Address - Country:US
Mailing Address - Phone:212-689-2022
Mailing Address - Fax:212-689-2780
Practice Address - Street 1:152 MADISON AVE
Practice Address - Street 2:SUITE 1000
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5424
Practice Address - Country:US
Practice Address - Phone:212-689-2022
Practice Address - Fax:212-689-2780
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0549651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNX3541Medicare ID - Type Unspecified