Provider Demographics
NPI:1497083992
Name:LESLIE, BEVERLEE A (LPC)
Entity Type:Individual
Prefix:
First Name:BEVERLEE
Middle Name:A
Last Name:LESLIE
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 1:254 9TH AVENUE DR NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-3828
Mailing Address - Country:US
Mailing Address - Phone:828-256-5656
Mailing Address - Fax:828-256-5658
Practice Address - Street 1:254 9TH AVENUE DR NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3828
Practice Address - Country:US
Practice Address - Phone:828-256-5656
Practice Address - Fax:828-256-5658
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7329101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional