Provider Demographics
NPI:1841202132
Name:KESSLER, LESLIE FRADKIN (LCSW C LICSW)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:FRADKIN
Last Name:KESSLER
Suffix:
Gender:F
Credentials:LCSW C LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6123 MONTROSE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852
Mailing Address - Country:US
Mailing Address - Phone:301-881-3700
Mailing Address - Fax:301-468-1862
Practice Address - Street 1:6123 MONTROSE RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852
Practice Address - Country:US
Practice Address - Phone:301-881-3700
Practice Address - Fax:301-468-1862
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12533104100000X
DCLC50077922104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD246877OtherKAISER
MD406719300Medicaid
MD7759627OtherAETNA
DCA2840138OtherBCBS OF DC
MD64301301OtherBCBS OF MD
MD776061000OtherMAGELLAN
MD776061000OtherMAGELLAN