Provider Demographics
NPI:1790539948
Name:WESTBROOK, LESLIE (LSW)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:WESTBROOK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 HAZLITT WAY
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4939
Mailing Address - Country:US
Mailing Address - Phone:908-635-1917
Mailing Address - Fax:
Practice Address - Street 1:415 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3001
Practice Address - Country:US
Practice Address - Phone:732-249-6410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06511800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker