Provider Demographics
NPI:1417532532
Name:WOOD, LESLIE LEISTRITZ (LPC)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:LEISTRITZ
Last Name:WOOD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1726 AUBURN DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-1448
Mailing Address - Country:US
Mailing Address - Phone:214-277-1193
Mailing Address - Fax:
Practice Address - Street 1:1726 AUBURN DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-1448
Practice Address - Country:US
Practice Address - Phone:214-277-1193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63828101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional