Provider Demographics
NPI:1144483165
Name:LESHER, MICHELLE S (LCADC)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:S
Last Name:LESHER
Suffix:
Gender:F
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:557 CENTRAL AVE APT 1B
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2122
Mailing Address - Country:US
Mailing Address - Phone:862-686-3186
Mailing Address - Fax:
Practice Address - Street 1:557 CENTRAL AVE APT 1B
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2122
Practice Address - Country:US
Practice Address - Phone:862-686-3186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY095690-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical