Provider Demographics
NPI:1174593586
Name:LEUSER, BART J (LISW)
Entity type:Individual
Prefix:
First Name:BART
Middle Name:J
Last Name:LEUSER
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2600 MARBLE NE
Mailing Address - Street 2:BUILDING 2
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-5391
Mailing Address - Country:US
Mailing Address - Phone:505-272-5022
Mailing Address - Fax:505-272-3466
Practice Address - Street 1:2600 MARBLE NE
Practice Address - Street 2:BUILDING 2
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-5391
Practice Address - Country:US
Practice Address - Phone:505-272-5022
Practice Address - Fax:505-272-3466
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMI-41521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical