Provider Demographics
NPI:1861801664
Name:FEDER, LESLIE (MSW)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:FEDER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 7TH ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-1220
Mailing Address - Country:US
Mailing Address - Phone:202-544-5035
Mailing Address - Fax:
Practice Address - Street 1:18 7TH ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-1220
Practice Address - Country:US
Practice Address - Phone:202-544-5035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500780631041C0700X
MD134781041C0700X
VA09040060821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical