Provider Demographics
NPI:1316951106
Name:GODWIN-ZUCKER, LESLIE ANNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ANNE
Last Name:GODWIN-ZUCKER
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 1:660 LINTON BLVD
Mailing Address - Street 2:#200 EX-1A
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-8167
Mailing Address - Country:US
Mailing Address - Phone:561-302-8353
Mailing Address - Fax:561-880-6982
Practice Address - Street 1:660 LINTON BLVD
Practice Address - Street 2:#200 EX-1A
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-8167
Practice Address - Country:US
Practice Address - Phone:561-302-8353
Practice Address - Fax:561-880-6982
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW30461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical