Provider Demographics
NPI:1093526527
Name:MCINTOSH, LESLIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:
Last Name:MCINTOSH
Suffix:
Gender:X
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 STEGMAN STREET
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305
Mailing Address - Country:US
Mailing Address - Phone:609-703-6125
Mailing Address - Fax:
Practice Address - Street 1:106 STEGMAN STREET
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305
Practice Address - Country:US
Practice Address - Phone:609-703-6125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No102X00000XBehavioral Health & Social Service ProvidersPoetry Therapist
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool