Provider Demographics
NPI:1174718936
Name:LEY, DAVID PRESTON (LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:PRESTON
Last Name:LEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 N LAKE SHORE DR
Mailing Address - Street 2:9B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-1862
Mailing Address - Country:US
Mailing Address - Phone:773-281-6587
Mailing Address - Fax:773-281-6587
Practice Address - Street 1:3530 N LAKE SHORE DR
Practice Address - Street 2:9B
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-1862
Practice Address - Country:US
Practice Address - Phone:773-281-6587
Practice Address - Fax:773-281-6587
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490008831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical