Provider Demographics
NPI:1023180593
Name:ANDREW, LESLIE ANN (LMHP CMSW)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ANN
Last Name:ANDREW
Suffix:
Gender:F
Credentials:LMHP CMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7847 STONEWALL CT
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-4172
Mailing Address - Country:US
Mailing Address - Phone:402-432-3317
Mailing Address - Fax:402-486-4992
Practice Address - Street 1:7847 STONEWALL CT
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-4172
Practice Address - Country:US
Practice Address - Phone:402-432-3317
Practice Address - Fax:402-486-4992
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE702101YM0800X
NE583104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE071342OtherVALUE OPTIONS
NE10025203100Medicaid
NE784682000OtherMAGELLAN
NE85213OtherBCBS OF NE
NE261192170OtherUBH
NE784682000OtherMIS NUMBER
NE83060OtherBLUE CROSS/BLUE SHIELD
NE90025OtherBCBS SUPERVISING NUMBER
NE911747525OtherCHAMPUS
NE911747525OtherUBH
NE4380OtherMIDLANDS CHOICE
NE10025568800Medicaid
NE90025OtherBCBS SUPERVISING NUMBER