Provider Demographics
NPI:1700027620
Name:BINNS, LEO WATERS JR (LCSW)
Entity Type:Individual
Prefix:
First Name:LEO
Middle Name:WATERS
Last Name:BINNS
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 N COBANE TER
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-4011
Mailing Address - Country:US
Mailing Address - Phone:973-669-2963
Mailing Address - Fax:973-669-2963
Practice Address - Street 1:26 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1834
Practice Address - Country:US
Practice Address - Phone:973-699-4962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC006798001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical