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Individual
LESLEY BERENSON
Active
Individual
LESLEY BERENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C003631
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447K
BCBS
—
01
—
185298
MEDCOST
—
05
—
6106377
—
NC
Enumeration date
12/02/2005
Last updated
11/19/2007
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