Individual
LESLIE M STAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC, LMHC
Contact information
Practice address
3368 WASHINGTON ST, BOSTON, MA 02130-2612
(617) 892-7827
(617) 522-0348
Mailing address
3368 WASHINGTON ST, BOSTON, MA 02130-2612
(617) 892-7827
(617) 522-0348
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
XL3442
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433129599
—
ME
01
—
9066
LICENSED MENTAL HEALTH COUNSELOR LICENSE NUMBER
MA
01
—
CC3690
LICENSED CLINICAL PROFESSIONAL COUNSELOR LICENSE NUMBER
ME
Enumeration date
10/09/2008
Last updated
12/18/2015
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