Provider Demographics
NPI:1205940269
Name:BLACK CURRIE, LESLIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:
Last Name:BLACK CURRIE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1943 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1625
Mailing Address - Country:US
Mailing Address - Phone:516-873-9830
Mailing Address - Fax:516-354-8363
Practice Address - Street 1:233 7TH ST
Practice Address - Street 2:3RD FLOOR, SUITE 300
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5747
Practice Address - Country:US
Practice Address - Phone:516-521-8685
Practice Address - Fax:516-354-8363
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0401611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP1257913OtherOXFORD HEALTH PLANS
NYNG8601OtherEMPIRE BC/BS