Provider Demographics
NPI:1902054430
Name:HEINS, LESLIE H (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:H
Last Name:HEINS
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 HEMLOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2627
Mailing Address - Country:US
Mailing Address - Phone:603-769-9463
Mailing Address - Fax:
Practice Address - Street 1:23 HEMLOCK HILL RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2627
Practice Address - Country:US
Practice Address - Phone:603-769-9463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1152791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical