Provider Demographics
NPI:1518666312
Name:TINGLE, LESLIEANN MCKINLEY (ALC)
Entity Type:Individual
Prefix:
First Name:LESLIEANN
Middle Name:MCKINLEY
Last Name:TINGLE
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9064 HELENA RD
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-2737
Mailing Address - Country:US
Mailing Address - Phone:205-528-6781
Mailing Address - Fax:
Practice Address - Street 1:9064 HELENA RD
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-2737
Practice Address - Country:US
Practice Address - Phone:205-644-1166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC04323101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor