Provider Demographics
NPI:1558576579
Name:SAKOW, LESLIE LEANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:LEANNE
Last Name:SAKOW
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:PO BOX 1988
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31702-1988
Mailing Address - Country:US
Mailing Address - Phone:229-430-4005
Mailing Address - Fax:229-430-4047
Practice Address - Street 1:2063 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BLAKELY
Practice Address - State:GA
Practice Address - Zip Code:39823-2267
Practice Address - Country:US
Practice Address - Phone:229-724-2206
Practice Address - Fax:229-724-2219
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0035801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical