Elizabeth M Leidolf, MA, MBA, LCADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

37LC00105900 Issued in NJ

Practice address

55 Chestnut St
Salem, NJ 08079-1443

Phone

(856) 878-1212

NPI assigned

May 22, 2012

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts, Master of Business Administration

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 22, 2012.

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337644800000",
    "number": "1679833859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CHESTNUT ST",
            "city": "SALEM",
            "state": "NJ",
            "postal_code": "080791443",
            "telephone_number": "856-878-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CHESTNUT ST",
            "city": "SALEM",
            "state": "NJ",
            "postal_code": "080791443",
            "telephone_number": "856-878-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIDOLF",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MA, MBA, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-22",
        "last_updated": "2012-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00105900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph A Lacavera III, D.O.
• Jacquelyn Laspada
• Legacy Treatment Serivces, Inc.
• Legacy Treatment Serivces, Inc.
• Legacy Treatment Services, Inc.
• Leigh H. Hopkins,MD,PC
• Primo Maestrado, MD
• Jeanne Mary Mahoney, RN, LPC
• David Gerard Marini
• Harriet A Mars

• All providers in Salem, NJ
• Addiction (Substance Use Disorder) Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; 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.