Provider Demographics
NPI:1336659234
Name:WILSON-CHARLES, LESLIE ERIN (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ERIN
Last Name:WILSON-CHARLES
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 JAVA WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-5740
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 CENTER PARK DR
Practice Address - Street 2:STE 111
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922
Practice Address - Country:US
Practice Address - Phone:865-973-9686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-05
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist