Provider Demographics
NPI:1194228437
Name:HALL, LESLEY ELLSWORTH (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LESLEY
Middle Name:ELLSWORTH
Last Name:HALL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:LEYLA
Other - Middle Name:ELLSWORTH
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:THRIVE CLINICAL & NATURAL THERAPEUTICS, PLLC
Mailing Address - Street 2:2007 N. COLLINS SUITE 301
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080
Mailing Address - Country:US
Mailing Address - Phone:214-232-6975
Mailing Address - Fax:
Practice Address - Street 1:THRIVE CLINICAL & NATURAL THERAPEUTICS, PLLC
Practice Address - Street 2:2007 N. COLLINS SUITE 301
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080
Practice Address - Country:US
Practice Address - Phone:214-232-6975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69437101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health