Provider Demographics
NPI:1770924979
Name:LEISTI, ROBYNE (MSW)
Entity type:Individual
Prefix:MS
First Name:ROBYNE
Middle Name:
Last Name:LEISTI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 HANCOCK ST
Mailing Address - Street 2:STE. 303
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5243
Mailing Address - Country:US
Mailing Address - Phone:617-479-0102
Mailing Address - Fax:
Practice Address - Street 1:1515 HANCOCK ST
Practice Address - Street 2:STE. 303
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5243
Practice Address - Country:US
Practice Address - Phone:617-479-0102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)