Provider Demographics
NPI:1083397137
Name:WYSE, LEKESHA RENEE' (LPC)
Entity Type:Individual
Prefix:
First Name:LEKESHA
Middle Name:RENEE'
Last Name:WYSE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LEKESHA
Other - Middle Name:RENEE'
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10637 HARCOURT TRCE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-6074
Mailing Address - Country:US
Mailing Address - Phone:334-301-4586
Mailing Address - Fax:
Practice Address - Street 1:7475 HALCYON POINTE DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-8053
Practice Address - Country:US
Practice Address - Phone:334-954-6010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLPC04913101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health