Provider Demographics
NPI:1669780037
Name:KAHN, LESLIE M (LCSW, PIP)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:M
Last Name:KAHN
Suffix:
Gender:F
Credentials:LCSW, PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43933
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-0933
Mailing Address - Country:US
Mailing Address - Phone:205-821-9758
Mailing Address - Fax:205-876-8018
Practice Address - Street 1:2018 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:SUITE 310
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6898
Practice Address - Country:US
Practice Address - Phone:205-329-7815
Practice Address - Fax:205-329-7816
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1652C, PIP1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical