Provider Demographics
NPI:1427393099
Name:STOUTE, LESLIE (PC)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:STOUTE
Suffix:
Gender:M
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8260 NORTHCREEK DR STE 380
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-6117
Mailing Address - Country:US
Mailing Address - Phone:531-271-0803
Mailing Address - Fax:
Practice Address - Street 1:8260 NORTHCREEK DR STE 380
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6117
Practice Address - Country:US
Practice Address - Phone:531-271-0803
Practice Address - Fax:513-272-4132
Is Sole Proprietor?:No
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC 1100041101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health