Provider Demographics
NPI:1487847257
Name:JENSBY, LESLIE M (LMSW)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:M
Last Name:JENSBY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 JONES ST
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:KS
Mailing Address - Zip Code:67042-1469
Mailing Address - Country:US
Mailing Address - Phone:316-322-9600
Mailing Address - Fax:
Practice Address - Street 1:119 JONES ST
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:KS
Practice Address - Zip Code:67042-1469
Practice Address - Country:US
Practice Address - Phone:316-322-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5446104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker