Provider Demographics
NPI:1093531097
Name:PALIGO, LEISL (LCSW)
Entity type:Individual
Prefix:
First Name:LEISL
Middle Name:
Last Name:PALIGO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 SANPAT LN APT A
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62902-0002
Mailing Address - Country:US
Mailing Address - Phone:765-490-3799
Mailing Address - Fax:
Practice Address - Street 1:1215 SANPAT LN APT A
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62902-0002
Practice Address - Country:US
Practice Address - Phone:765-490-3799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0268221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical