Provider Demographics
NPI:1043900715
Name:MINAKAWA, LEINA (LCSW)
Entity type:Individual
Prefix:
First Name:LEINA
Middle Name:
Last Name:MINAKAWA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MARY HADGE DR
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-3410
Mailing Address - Country:US
Mailing Address - Phone:518-265-9906
Mailing Address - Fax:
Practice Address - Street 1:12 MARY HADGE DR
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-3410
Practice Address - Country:US
Practice Address - Phone:518-265-9906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0597441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical