Leslie R Selby, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05945300 Issued in NJ

Practice address

76 W Jimmie Leeds Rd Ste 305
Galloway, NJ 08205-9418

Phone

(609) 573-5260

NPI assigned

Oct 9, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: leslie@familyempowerment.net

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1265030530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 W JIMMIE LEEDS RD STE 305",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059418",
            "telephone_number": "609-573-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 W JIMMIE LEEDS RD STE 305",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059418",
            "telephone_number": "609-573-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELBY",
        "first_name": "LESLIE",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05945300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Leslie@familyempowerment.net",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "76 W Jimmie Leeds Rd Ste 305",
            "city": "Galloway",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "082059418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Robert Seckinger
• Christina Seel, LSW
• Elena V Selina, M.D.
• Sharon Leigh Sergeant, PT, DPT
• Shane Shackford, PSY.D
• Jack Shakarshy, MD
• Sharon Carroccia LCSW, LLC

• Clinical Social Worker in Galloway, NJ
• Providers in Galloway, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.