Provider Demographics
NPI:1609915438
Name:SLESZYNSKI, LINDA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:SLESZYNSKI
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 1:140 FELL CT
Mailing Address - Street 2:SUITE 120A
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-4360
Mailing Address - Country:US
Mailing Address - Phone:631-754-7837
Mailing Address - Fax:631-300-3501
Practice Address - Street 1:140 FELL CT
Practice Address - Street 2:SUITE 120A
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-4360
Practice Address - Country:US
Practice Address - Phone:631-754-7837
Practice Address - Fax:631-300-3501
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP0556751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN6Z782Medicare ID - Type Unspecified