Basic Information
| Provider Information | |||||||||
| NPI: | 1356548523 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LESLIE E MORATO CISW PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1951 N WILMOT RD | ||||||||
| Address2: | BLDG 1 SUITE 2 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857128000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207223777 | ||||||||
| FaxNumber: | 5202966224 | ||||||||
| Practice Location | |||||||||
| Address1: | 5920 E PIMA ST | ||||||||
| Address2: | SUITE 140 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857124306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207332524 | ||||||||
| FaxNumber: | 5207333444 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2007 | ||||||||
| LastUpdateDate: | 05/27/2009 | ||||||||
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| AuthorizedOfficialLastName: | MORATO | ||||||||
| AuthorizedOfficialFirstName: | LESLIE | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5207332524 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCSW0763 | AZ | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.