Provider Demographics
NPI:1194082412
Name:SANTA, LESLIE KALINER (LICSW)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:KALINER
Last Name:SANTA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:SARA
Other - Last Name:KALINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1725 NEW HAMPSHIRE AVE NW
Mailing Address - Street 2:APT 507
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-2566
Mailing Address - Country:US
Mailing Address - Phone:202-656-8515
Mailing Address - Fax:202-483-4243
Practice Address - Street 1:1555 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 4E
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1111
Practice Address - Country:US
Practice Address - Phone:202-656-8515
Practice Address - Fax:202-483-4243
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500791901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical