Provider Demographics
NPI:1598967234
Name:KROHN, LESLIE MARCIA (LCSWC)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:MARCIA
Last Name:KROHN
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12606 WORTHINGTON RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-5520
Mailing Address - Country:US
Mailing Address - Phone:410-356-1511
Mailing Address - Fax:
Practice Address - Street 1:6301 N CHARLES ST
Practice Address - Street 2:SUITE 8
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-1047
Practice Address - Country:US
Practice Address - Phone:410-377-6370
Practice Address - Fax:410-377-6516
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD042821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical