Provider Demographics
NPI:1225402357
Name:COLE, LESLIE (LCDC, LPC-I)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:COLE
Suffix:
Gender:F
Credentials:LCDC, LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 K AVENUE SUITE 102
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074
Mailing Address - Country:US
Mailing Address - Phone:972-423-8727
Mailing Address - Fax:
Practice Address - Street 1:2600 K AVE STE 102
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5306
Practice Address - Country:US
Practice Address - Phone:972-423-8727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12819101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)