Provider Demographics
NPI:1518460831
Name:PINKELMAN, LESLIE PERRIN (LCSW)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:PERRIN
Last Name:PINKELMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:ANN
Other - Last Name:PERRIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10080 E MOUNTAINVIEW LAKE DR UNIT 235
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5285
Mailing Address - Country:US
Mailing Address - Phone:650-823-9408
Mailing Address - Fax:
Practice Address - Street 1:10080 E MOUNTAINVIEW LAKE DR UNIT 235
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5285
Practice Address - Country:US
Practice Address - Phone:650-823-9408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA144811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA14481OtherLCSW