Provider Demographics
NPI:1356136287
Name:PEREZ, LESLY (LSW)
Entity type:Individual
Prefix:
First Name:LESLY
Middle Name:
Last Name:PEREZ
Suffix:
Gender:
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2306 CAMELOT CT
Mailing Address - Street 2:
Mailing Address - City:HELMETTA
Mailing Address - State:NJ
Mailing Address - Zip Code:08828-2508
Mailing Address - Country:US
Mailing Address - Phone:201-362-1725
Mailing Address - Fax:
Practice Address - Street 1:430 MOUNTAIN AVE STE 304
Practice Address - Street 2:
Practice Address - City:NEW PROVIDENCE
Practice Address - State:NJ
Practice Address - Zip Code:07974-2731
Practice Address - Country:US
Practice Address - Phone:201-362-1725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-11
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL069752001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical