Provider Demographics
NPI:1164576278
Name:ENGELBRECHT, LESTER JOHN (LMHC)
Entity Type:Individual
Prefix:MR
First Name:LESTER
Middle Name:JOHN
Last Name:ENGELBRECHT
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 MEADOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-5849
Mailing Address - Country:US
Mailing Address - Phone:518-798-4703
Mailing Address - Fax:
Practice Address - Street 1:113 MEADOWBROOK RD
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-5849
Practice Address - Country:US
Practice Address - Phone:518-793-4187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000074101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000074OtherLMHC