| Doctor Name: | MS. LESLEY ANN ELLIS |
| NPI Number: | 1629292032 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LICSW |
| License Number: | LC50078627 |
| Business Practice Address: | 12138 Central Avenue #662 Mitchellville, MD - 20721 |
| Business Phone Number: | 3013363242 |
| Business Fax Number: | |
| Mailing Address: | 12138 Central Avenue, #662 MITCHELLVILLE |
| State: | MD |
| Postal Code: | 20721 |
| Phone Number: | 3013363242 |
| Fax Number: | |
| NPI Enumeration Date: | 04/13/2007 |
| NPI Last Update Date: | 02/03/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LC50078627 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | DC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |