Provider Demographics
NPI:1649581273
Name:LEFF, AVIGAYL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AVIGAYL
Middle Name:
Last Name:LEFF
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 1:75 RARITAN AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2442
Mailing Address - Country:US
Mailing Address - Phone:732-993-8008
Mailing Address - Fax:267-645-7346
Practice Address - Street 1:75 RARITAN AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2442
Practice Address - Country:US
Practice Address - Phone:732-993-8008
Practice Address - Fax:267-645-7346
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05569700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker