Provider Demographics
NPI:1356030977
Name:PARETZKY, LEAH
Entity type:Individual
Prefix:MS
First Name:LEAH
Middle Name:
Last Name:PARETZKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 S SOUTHGATE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-2022
Mailing Address - Country:US
Mailing Address - Phone:845-499-5332
Mailing Address - Fax:
Practice Address - Street 1:259 GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-2806
Practice Address - Country:US
Practice Address - Phone:845-362-8362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0941161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical