Provider Demographics
NPI:1639577067
Name:WORLEY, LESLIE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:WORLEY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5344 LIGHTNING VIEW RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2241
Mailing Address - Country:US
Mailing Address - Phone:131-751-4113
Mailing Address - Fax:
Practice Address - Street 1:5 TIVOLI LAKE CT
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-5904
Practice Address - Country:US
Practice Address - Phone:202-810-3309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-17
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18778101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health