Provider Demographics
NPI:1508991183
Name:LEISTER, MARGARET (CADC, LCDP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:LEISTER
Suffix:
Gender:F
Credentials:CADC, LCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 S GOVERNORS AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-7020
Mailing Address - Country:US
Mailing Address - Phone:302-678-4558
Mailing Address - Fax:302-678-4577
Practice Address - Street 1:1550 S GOVERNORS AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-7020
Practice Address - Country:US
Practice Address - Phone:302-678-4558
Practice Address - Fax:302-678-4577
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE7941041C0700X
DECD0000026101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000022542Medicaid
DE1000030483Medicaid