Provider Demographics
NPI:1568658961
Name:MARTEL, LESLIE PATRICE (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:LESLIE
Middle Name:PATRICE
Last Name:MARTEL
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 1:2156 LAKEVIEW DR
Mailing Address - Street 2:257
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-6738
Mailing Address - Country:US
Mailing Address - Phone:734-649-4946
Mailing Address - Fax:
Practice Address - Street 1:3333 GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2426
Practice Address - Country:US
Practice Address - Phone:419-259-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801062245101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health