Provider Demographics
NPI:1962421206
Name:MCCARL, LESLIE J (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:J
Last Name:MCCARL
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 1:152 E MARKET ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-2160
Mailing Address - Country:US
Mailing Address - Phone:717-348-0072
Mailing Address - Fax:
Practice Address - Street 1:152 E MARKET ST
Practice Address - Street 2:SUITE 111
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-2160
Practice Address - Country:US
Practice Address - Phone:717-348-0072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0151781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019279200005Medicaid
PA387227Medicare PIN