Provider Demographics
NPI:1356548523
Name:LESLIE E MORATO CISW PLLC
Entity type:Organization
Organization Name:LESLIE E MORATO CISW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MORATO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:520-733-2524
Mailing Address - Street 1:1951 N WILMOT RD
Mailing Address - Street 2:BLDG 1 SUITE 2
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-8000
Mailing Address - Country:US
Mailing Address - Phone:520-722-3777
Mailing Address - Fax:520-296-6224
Practice Address - Street 1:5920 E PIMA ST
Practice Address - Street 2:SUITE 140
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4306
Practice Address - Country:US
Practice Address - Phone:520-733-2524
Practice Address - Fax:520-733-3444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW07631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ73365Medicare PIN
S27265Medicare UPIN