Provider Demographics
NPI:1770738171
Name:LAUF, LESLIE ANN (LICSW)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANN
Last Name:LAUF
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 FEARING ST STE 15
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1945
Mailing Address - Country:US
Mailing Address - Phone:413-404-0035
Mailing Address - Fax:413-265-2813
Practice Address - Street 1:150 FEARING ST STE 15
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-1945
Practice Address - Country:US
Practice Address - Phone:413-404-0035
Practice Address - Fax:413-265-2813
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MA1188641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor