Provider Demographics
NPI:1508158098
Name:SPRINGER, LESLIE ANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANNE
Last Name:SPRINGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:ANNE
Other - Last Name:SADOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:696 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3106
Mailing Address - Country:US
Mailing Address - Phone:917-340-4089
Mailing Address - Fax:
Practice Address - Street 1:696 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3106
Practice Address - Country:US
Practice Address - Phone:917-340-4089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054584001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical