Leah Lisa Mandelbaum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

070497-1 Issued in NY

Practice address

2795 Richmond Ave
Staten Island, NY 10314-5857

Phone

(718) 761-9800

Fax

(718) 370-1142

NPI assigned

Nov 1, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185840000000",
    "number": "1679650329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 CENTRAL AVE APT 115",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162207",
            "telephone_number": "516-569-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2795 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145857",
            "telephone_number": "718-761-9800",
            "fax_number": "718-370-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDELBAUM",
        "first_name": "LEAH",
        "middle_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "070497-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank J. Mandarino, D.C.
• Jennifer Lynne Mandato Trucios, CASAC-T, CRPA-P
• Karen Mandel, M.S.ED.
• Nicole Mandel
• Taryn Felise Mandel
• Barry Mandell, D.D.S.
• Gurpreet Kaur Mander, OTR/L
• Anthony Stephen Mandracchia, DC
• Christina Mandry
• Bruno Manduca, M.D.

• Clinical Social Worker in Staten Island, NY
• Providers in Staten Island, 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 31, 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.