Provider Demographics
NPI:1184185241
Name:MARTHA L LEESMAN MS PLLC
Entity Type:Organization
Organization Name:MARTHA L LEESMAN MS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEESMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:210-606-6861
Mailing Address - Street 1:1850 LOCKHILL SELMA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1552
Mailing Address - Country:US
Mailing Address - Phone:210-606-6861
Mailing Address - Fax:
Practice Address - Street 1:1850 LOCKHILL SELMA RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-1552
Practice Address - Country:US
Practice Address - Phone:210-606-6861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty