Provider Demographics
NPI:1750583167
Name:HUNTER, LESLIE CRANDALL (LICSW, LCSW-C)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:CRANDALL
Last Name:HUNTER
Suffix:
Gender:F
Credentials:LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4025 13TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2611
Mailing Address - Country:US
Mailing Address - Phone:202-841-8829
Mailing Address - Fax:202-387-3049
Practice Address - Street 1:4025 13TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2611
Practice Address - Country:US
Practice Address - Phone:202-841-8829
Practice Address - Fax:202-387-3049
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD157701041C0700X
VA09040109681041C0700X
DCLC500805121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical