Provider Demographics
NPI:1407008832
Name:GUNTER, LESLIE R (LCSW)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:R
Last Name:GUNTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 E GUNDERSEN STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2043
Mailing Address - Country:US
Mailing Address - Phone:630-871-2100
Mailing Address - Fax:630-588-0824
Practice Address - Street 1:336 E GUNDERSEN STREET
Practice Address - Street 2:SUITE B
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2403
Practice Address - Country:US
Practice Address - Phone:630-871-2100
Practice Address - Fax:630-588-0824
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0113401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical