Provider Demographics
NPI:1407486566
Name:VASCONEZ, LESLIE YESENIA (LMHC)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:YESENIA
Last Name:VASCONEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 N FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4305
Mailing Address - Country:US
Mailing Address - Phone:347-496-9566
Mailing Address - Fax:
Practice Address - Street 1:151 N FOREST AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4305
Practice Address - Country:US
Practice Address - Phone:347-496-9566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health