Provider Demographics
NPI:1801478433
Name:LESHCHINER, MATTHEW L (MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:L
Last Name:LESHCHINER
Suffix:
Gender:M
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14904 DUNVEGAN CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-5769
Mailing Address - Country:US
Mailing Address - Phone:202-906-0388
Mailing Address - Fax:
Practice Address - Street 1:2 TAFT CT
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1390
Practice Address - Country:US
Practice Address - Phone:202-695-5329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-23
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR231558363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health