Provider Demographics
NPI:1922151943
Name:LESLIE LESHNER, ELIZABETH (MSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:LESLIE LESHNER
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 1:1471 BECKER DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-4645
Mailing Address - Country:US
Mailing Address - Phone:513-379-0635
Mailing Address - Fax:513-939-3301
Practice Address - Street 1:1251 NILLES RD
Practice Address - Street 2:SUITE 7
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-7206
Practice Address - Country:US
Practice Address - Phone:513-379-0635
Practice Address - Fax:513-939-3301
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00039611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical