Provider Demographics
NPI:1306985130
Name:LEEMAN-WEIL, BETHANY MARIE (MSW, LICSW)
Entity type:Individual
Prefix:MS
First Name:BETHANY
Middle Name:MARIE
Last Name:LEEMAN-WEIL
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:MS
Other - First Name:BETHANY
Other - Middle Name:MARIE
Other - Last Name:LEEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:99 CLAPP ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-3245
Mailing Address - Country:US
Mailing Address - Phone:617-882-2122
Mailing Address - Fax:888-991-6938
Practice Address - Street 1:99 CLAPP ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-3245
Practice Address - Country:US
Practice Address - Phone:617-882-2122
Practice Address - Fax:888-991-6938
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1142041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical