Provider Demographics
NPI:1376528505
Name:BEECH, LESLIE ANN (MA LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:ANN
Last Name:BEECH
Suffix:
Gender:F
Credentials:MA LCSW
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:ANN
Other - Last Name:BEITCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10425 OLD OLIVE STREET RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141
Mailing Address - Country:US
Mailing Address - Phone:314-991-3993
Mailing Address - Fax:314-991-3993
Practice Address - Street 1:10425 OLD OLIVE STREET RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141
Practice Address - Country:US
Practice Address - Phone:314-991-3993
Practice Address - Fax:314-991-3993
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW0017181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical