Provider Demographics
NPI:1043853260
Name:WEST, LESLIE ALISON (MS, LPC-INTERN, NCC)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ALISON
Last Name:WEST
Suffix:
Gender:F
Credentials:MS, LPC-INTERN, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 PEMBERTON HILL RD BLDG 4
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75217-5209
Mailing Address - Country:US
Mailing Address - Phone:512-289-8005
Mailing Address - Fax:
Practice Address - Street 1:811 PEMBERTON HILL RD BLDG 4
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-5209
Practice Address - Country:US
Practice Address - Phone:512-289-8005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79471101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health