Provider Demographics
NPI:1477340685
Name:FRITJOFSON, LESLIE (LCSW)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:FRITJOFSON
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 CONCORD DR
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-3212
Mailing Address - Country:US
Mailing Address - Phone:954-296-7980
Mailing Address - Fax:
Practice Address - Street 1:1035 S SEMORAN BLVD STE 1027
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-5512
Practice Address - Country:US
Practice Address - Phone:954-296-7980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW239701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical