Provider Demographics
NPI:1033991971
Name:MORRIS, LESLIE (LMHCA)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5831 LACEY BLVD SE STE G
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-7241
Mailing Address - Country:US
Mailing Address - Phone:360-402-0750
Mailing Address - Fax:
Practice Address - Street 1:5831 LACEY BLVD SE STE G
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-7241
Practice Address - Country:US
Practice Address - Phone:360-402-0750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61445934101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health