Provider Demographics
NPI:1396378139
Name:THOMPSON, LESLIE (LMSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LMSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 DUNCAN CIR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-3560
Mailing Address - Country:US
Mailing Address - Phone:316-680-7577
Mailing Address - Fax:
Practice Address - Street 1:6300 N REVERE DR STE 270
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64151-3919
Practice Address - Country:US
Practice Address - Phone:913-735-0577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20190167141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical