Provider Demographics
NPI:1225568090
Name:BOSWORTH, LESLIE (LICSW)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:BOSWORTH
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 1:34 SODEN ST # 3
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3154
Mailing Address - Country:US
Mailing Address - Phone:857-301-7424
Mailing Address - Fax:617-607-7555
Practice Address - Street 1:34 SODEN ST # 3
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3154
Practice Address - Country:US
Practice Address - Phone:857-301-7424
Practice Address - Fax:617-607-7555
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1184111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical