Provider Demographics
NPI:1073120374
Name:ALTON, LESLIE (LPC)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:ALTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S MICHIGAN AVE STE 928
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-1617
Mailing Address - Country:US
Mailing Address - Phone:312-248-3190
Mailing Address - Fax:
Practice Address - Street 1:401 S MICHIGAN AVE STE 928
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-1617
Practice Address - Country:US
Practice Address - Phone:312-248-3190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health