Provider Demographics
NPI:1033242573
Name:STUART, LESLIE A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:A
Last Name:STUART
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:LESLIE
Other - Middle Name:A
Other - Last Name:APFELBAUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1100 JOHNSON FERRY RD NE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1709
Mailing Address - Country:US
Mailing Address - Phone:404-943-9494
Mailing Address - Fax:678-399-9635
Practice Address - Street 1:1100 JOHNSON FERRY RD NE
Practice Address - Street 2:SUITE 230
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1709
Practice Address - Country:US
Practice Address - Phone:404-943-9494
Practice Address - Fax:678-399-9635
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2437103TC0700X, 103TC2200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103T00000XBehavioral Health & Social Service ProvidersPsychologist