Provider Demographics
NPI:1700300852
Name:SCHROETER, LESLEY VIRGINIA (LCSW)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:VIRGINIA
Last Name:SCHROETER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8249 CROWN COLONY PKWY # 200
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-4057
Mailing Address - Country:US
Mailing Address - Phone:804-789-1224
Mailing Address - Fax:804-789-9564
Practice Address - Street 1:156 COLLEGE ST STE 201
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-8423
Practice Address - Country:US
Practice Address - Phone:802-310-1408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
VA1041C0700X
VT089.01343581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker