Provider Demographics
NPI:1922184662
Name:TOPEK-WALKER, LEAH (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:
Last Name:TOPEK-WALKER
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 N OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-2004
Mailing Address - Country:US
Mailing Address - Phone:516-524-4554
Mailing Address - Fax:631-588-8901
Practice Address - Street 1:168 N OCEAN AVE
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-2004
Practice Address - Country:US
Practice Address - Phone:516-524-4554
Practice Address - Fax:631-588-8901
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077631-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03346765Medicaid
NY03346765Medicaid