Provider Demographics
NPI:1891109518
Name:SOULEK, LESLIE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:
Last Name:SOULEK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 SE FEDERAL HWY # 1012
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-5531
Mailing Address - Country:US
Mailing Address - Phone:772-218-0642
Mailing Address - Fax:772-219-8729
Practice Address - Street 1:5124 SE HARBOR TER
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-2572
Practice Address - Country:US
Practice Address - Phone:772-218-0642
Practice Address - Fax:772-219-8729
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-20
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker