Doctor Name: | LESLIE J PORRECA |
NPI Number: | 1093981177 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 089.0073008 |
Business Practice Address: | 56 Howard Hill Rd Benson, VT - 057439432 |
Business Phone Number: | 8025374531 |
Business Fax Number: | 8025374531 |
Mailing Address: | 273 W Uwchlan Ave, DOWNINGTOWN |
State: | PA |
Postal Code: | 193353361 |
Phone Number: | 8025374531 |
Fax Number: | 8025374531 |
NPI Enumeration Date: | 05/07/2008 |
NPI Last Update Date: | 07/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 089.0073008 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |