Provider Demographics
NPI:1710621131
Name:JAWORSKI, LESLIE S (LMHC)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:S
Last Name:JAWORSKI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SPARROW DR APT 208
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1620
Mailing Address - Country:US
Mailing Address - Phone:561-275-0887
Mailing Address - Fax:
Practice Address - Street 1:1166 E BLUE HERON BLVD
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-4738
Practice Address - Country:US
Practice Address - Phone:561-295-7613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18979101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health