Leslie A Waller I, LCSW-RP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

RP014837-1 Issued in NY

Practice address

1901 1St Ave
Metropolitan Hospital
New York, NY 10029-7404

Phone

(212) 423-6448

Fax

(212) 426-6326

NPI assigned

Nov 21, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558436196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 CENTRAL PARK W",
            "address_2": "APT. # 9N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256054",
            "telephone_number": "212-866-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE",
            "address_2": "METROPOLITAN HOSPITAL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297404",
            "telephone_number": "212-423-6448",
            "fax_number": "212-426-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "LESLIE",
        "middle_name": "A",
        "name_suffix": "I",
        "credential": "LCSW-RP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RP014837-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RP14837-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alison D Wallack, M.S.
• Joel J Wallack, M.D.
• Marc Kenneth Wallack, M.D.
• Anna Waller, PHD
• John Felix Waller, M.D.
• Samantha Waller
• Alexa Rose Wallerstein, LMHC
• Avery Wallerstein
• Samson Wallerstein, MS
• Pia Wallgren, LCSW

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.