Provider Demographics
NPI:1245983394
Name:LESLIE DUFF THERAPY PLLC
Entity type:Organization
Organization Name:LESLIE DUFF THERAPY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUFF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-845-5698
Mailing Address - Street 1:488 N MAIN ST APT 2N
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5126
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:488 N MAIN ST APT 2N
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5126
Practice Address - Country:US
Practice Address - Phone:847-845-5698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LESLIE DUFF THERAPY PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-29
Last Update Date:2022-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty