Provider Demographics
NPI:1821624008
Name:POLIN, LEIGH BLAINE (SOCIAL WORKER, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LEIGH
Middle Name:BLAINE
Last Name:POLIN
Suffix:
Gender:F
Credentials:SOCIAL WORKER, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:499 MAIN ST FL 2
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-1464
Mailing Address - Country:US
Mailing Address - Phone:848-207-4670
Mailing Address - Fax:
Practice Address - Street 1:499 MAIN ST FL 2
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1464
Practice Address - Country:US
Practice Address - Phone:848-207-4670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2022-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05313900101YM0800X
NJ44SC059658001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health