Provider Demographics
NPI:1497352637
Name:OSTAD-HASHEMI, LEILA (LCSW)
Entity Type:Individual
Prefix:
First Name:LEILA
Middle Name:
Last Name:OSTAD-HASHEMI
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 1:95 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FERRY
Mailing Address - State:NJ
Mailing Address - Zip Code:07643-1720
Mailing Address - Country:US
Mailing Address - Phone:646-740-4494
Mailing Address - Fax:
Practice Address - Street 1:95 UNION AVE
Practice Address - Street 2:
Practice Address - City:LITTLE FERRY
Practice Address - State:NJ
Practice Address - Zip Code:07643-1720
Practice Address - Country:US
Practice Address - Phone:646-740-4494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE