Provider Demographics
NPI:1003654757
Name:SANTANA, LESLIE ANN (LMSW)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ANN
Last Name:SANTANA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1749 GRAND CONCOURSE APT 12Q
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-8223
Mailing Address - Country:US
Mailing Address - Phone:347-500-2155
Mailing Address - Fax:
Practice Address - Street 1:2474 CROTONA AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-6402
Practice Address - Country:US
Practice Address - Phone:718-584-3328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY123943104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker