Provider Demographics
NPI:1679355267
Name:LEFFLER, MICHAEL ARTHUR (LMSW)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ARTHUR
Last Name:LEFFLER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:A
Other - Last Name:LEFFLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:2524 W FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:PA
Mailing Address - Zip Code:18603-4112
Mailing Address - Country:US
Mailing Address - Phone:859-312-1276
Mailing Address - Fax:
Practice Address - Street 1:53 W FOOTHILLS DR
Practice Address - Street 2:
Practice Address - City:DRUMS
Practice Address - State:PA
Practice Address - Zip Code:18222-2405
Practice Address - Country:US
Practice Address - Phone:570-606-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW140714104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker