Individual
LESLIE FITZWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
300 S LEA AVE # 4, ROSWELL, NM 88203-4562
(575) 347-1883
(737) 201-2725
Mailing address
PO BOX 102, ROSWELL, NM 88202-0102
(575) 347-1883
(737) 201-2725
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
SWB20220948
NM
1041C0700X
Clinical Social Worker
Primary
SWB-2025-1396
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85109801
—
NM
Enumeration date
07/27/2023
Last updated
03/05/2026
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