LESLIE D. MAVROMATIS (NPI# 1922546175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922546175 |
| Entity Type | Individual |
| Full Name | LESLIE D. MAVROMATIS |
| Credential | LICSW |
| Practice Address |
527 Medical Park Dr Bridgeport WV 26330-9008 |
| Practice Telephone | 3049333885 |
| Practice Fax Number | 3049333887 |
| Mailing Telephone | 3049333885 |
| Mailing Fax Number | 3049333887 |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2017-02-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
DP00944782 | WV | Behavioral Health & Social Service Providers |
| Street Address |
527 MEDICAL PARK DR |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330-9008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134101660 | United Hospital Center Inc | Family Medicine | 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9010 | 2005-11-18 |
| 1760967400 | Susan Rennae Kirkendall | Counselor | 527 Medical Park Dr, Bridgeport, WV 26330-9008 | 2018-09-28 |
| 1457886988 | Rachel S Holeman | Student in an Organized Health Care Education/Training Program | 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 | 2017-04-21 |
| 1205360237 | Nathan E Russell | Student in an Organized Health Care Education/Training Program | 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 | 2017-04-17 |
| 1255865275 | Brandon M Lewko | Emergency Medicine | 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 | 2017-04-17 |
| 1144754177 | Premkumar Chandrakantbhai Patel | General Practice | 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 | 2017-04-17 |
| 1316491996 | Ellen Palmer Hoban | Nurse Practitioner | 527 Medical Park Dr, Suite 105, Bridgeport, WV 26330-9008 | 2016-08-11 |
| 1194170571 | Matthan Jackson | Family Medicine | 527 Medical Park Dr, Ste 500, Bridgeport, WV 26330-9008 | 2016-05-04 |
| 1447605837 | Arsalan Khawaja | Student in an Organized Health Care Education/Training Program | 527 Medical Park Dr, Ste 500, Bridgeport, WV 26330-9008 | 2016-05-04 |
| 1902251374 | Kristin Black | Student in an Organized Health Care Education/Training Program | 527 Medical Park Dr, Ste 500, Bridgeport, WV 26330-9008 | 2016-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303036 | Gage Mackenzie Chichester | Nurse Anesthetist, Certified Registered | 2673 Medical Park Drive, Bridgeport, WV 26330 | 2020-10-12 |
| 1851914105 | Melany Langhurst | Social Worker | 64 Professional Place, Suite 102, Bridgeport, WV 26330 | 2020-05-21 |
| 1245704980 | Adam Christopher Stonestreet | Social Worker | Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 | 2019-01-16 |
| 1588146658 | Bridgeport Physical Therapy Services, Inc. | Occupational Therapist | 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 | 2018-09-05 |
| 1275040685 | White Oaks Assisted Living | Assisted Living Facility | 140 Professional Place White Oaks, Bridgeport, WV 26330 | 2018-01-08 |
| 1275049371 | Regional Eye Associates, Inc | Ophthalmology | 220 Southview Drive, Bridgeport, WV 26330 | 2017-12-27 |
| 1528586187 | Savanna Tamia Brown | Social Worker | 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 | 2017-09-05 |
| 1184079642 | Karla Kay Rinehart | Social Worker | 27 Trovato St., Suite 103, Bridgeport, WV 26330 | 2016-05-03 |
| 1396176756 | Willo Group LLC | Pharmacy | 460 E. Main Street, Bridgeport, WV 26330 | 2013-12-10 |
| 1891031878 | Sherri Michelle Dobson | Occupational Therapy Assistant | 1000 Maplewood Dr, Bridgeport, WV 26330 | 2012-12-20 |
| Find all providers in zip 26330 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528666955 | Emily Mariah Wolf | Counselor | 1154 Walnut Grove Rd, Bridgeport, NY 13030-9760 | 2020-10-16 |
| 1437760071 | Danielle Gofman | Counselor | 2675 Park Ave Unit 29, Bridgeport, CT 06604-1356 | 2020-08-16 |
| 1134691868 | Margaret Katherine Leska | Counselor | 180 Fairfield Ave # 1, Bridgeport, CT 06604-4252 | 2018-12-19 |
| 1124595772 | Julia Frank | Counselor | 4699 Main St Ste 105, Bridgeport, CT 06606-1830 | 2018-10-31 |
| 1801267265 | Zachary Grill | Counselor | 123 Gilman St, Bridgeport, CT 06605-3314 | 2015-10-12 |
| 1992185102 | Juliet Jacob | Counselor | 3250 Fairfield Ave Apt 317, Bridgeport, CT 06605-3273 | 2015-06-02 |
| 1477958080 | Luis Alejandro Castellon Jr. | Counselor | 121 Frank St, Bridgeport, CT 06604-3202 | 2014-10-24 |
| 1669877379 | Devana Campbell | Counselor | 15 Heritage Pl, Bridgeport, CT 06606-1314 | 2014-10-24 |
| 1760887475 | Pryndall Marie White | Counselor | 955 Main St Apt 906, Bridgeport, CT 06604-4319 | 2014-10-24 |
| 1669744611 | Tdat Transitional Development and Training | Counselor | 70 Lincoln Blvd, Bridgeport, CT 06606-5550 | 2012-02-07 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 26330 |
Please comment or provide details below to improve the information on LESLIE D. MAVROMATIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.