Provider Demographics
NPI:1235274010
Name:LESLIE, JEAN MARIE (MA, LPCC-S)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:MARIE
Last Name:LESLIE
Suffix:
Gender:F
Credentials:MA, LPCC-S
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:MARIE
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPCC-S
Mailing Address - Street 1:453 WATERBURY COURT
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-5309
Mailing Address - Country:US
Mailing Address - Phone:614-216-0547
Mailing Address - Fax:855-875-6734
Practice Address - Street 1:453 WATERBURY COURT
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-5309
Practice Address - Country:US
Practice Address - Phone:614-216-0547
Practice Address - Fax:855-875-6734
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE2897101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional