Individual provider · Type 1 NPI

Leslie K. Gannon

Clinical Social Worker · Whitefish Bay, WI

NPI number 1316295272 Active

Practice location

5573 N Diversey Blvd
Whitefish Bay, WI 53217-5202

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X7490-123 (WI)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1316295272

Leslie K. Gannon's National Provider Identifier is 1316295272, issued on Aug 27, 2012. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Whitefish Bay, WI. The record was last updated on Aug 27, 2012.