Provider Demographics
NPI:1508338930
Name:MAIZEL, LESLIE (LCSW)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:MAIZEL
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 1:132 BRANDON CT
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08853-4232
Mailing Address - Country:US
Mailing Address - Phone:908-336-8880
Mailing Address - Fax:
Practice Address - Street 1:491 AMWELL RD STE 103
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-8212
Practice Address - Country:US
Practice Address - Phone:908-431-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-24
Last Update Date:2018-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052390001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical