Provider Demographics
NPI:1356447577
Name:HAYES, LESLEY A (LCSW 10123)
Entity Type:Individual
Prefix:MRS
First Name:LESLEY
Middle Name:A
Last Name:HAYES
Suffix:
Gender:F
Credentials:LCSW 10123
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15264 N 54TH AVE APT SUITE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-3412
Mailing Address - Country:US
Mailing Address - Phone:623-694-9291
Mailing Address - Fax:602-938-1626
Practice Address - Street 1:18205 N 51ST AVE STE 113
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1491
Practice Address - Country:US
Practice Address - Phone:623-694-9291
Practice Address - Fax:602-938-1626
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-101231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical