Provider Demographics
NPI:1558869107
Name:LOPP, LESLIE LISKER (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:LISKER
Last Name:LOPP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:LESLIE
Other - Middle Name:ANN
Other - Last Name:LISKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 ALDENSHIRE PL
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-5658
Mailing Address - Country:US
Mailing Address - Phone:404-579-8818
Mailing Address - Fax:
Practice Address - Street 1:310 ALDENSHIRE PL
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-5658
Practice Address - Country:US
Practice Address - Phone:404-579-8818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009609101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional