Provider Demographics
NPI:1376776427
Name:HILL, LESLEY E (LMFT)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:E
Last Name:HILL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MEDICINE LODGE
Mailing Address - State:KS
Mailing Address - Zip Code:67104-1046
Mailing Address - Country:US
Mailing Address - Phone:913-669-7889
Mailing Address - Fax:
Practice Address - Street 1:2537 EISENHOWER RD
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-9482
Practice Address - Country:US
Practice Address - Phone:785-242-3780
Practice Address - Fax:785-242-6397
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMFT 1088106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist