Provider Demographics
NPI:1659507424
Name:ROBERTS, LESLIE ROCHELLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:ROCHELLE
Last Name:ROBERTS
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 1:16749 LITTLE LEAF CT
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-0678
Mailing Address - Country:US
Mailing Address - Phone:405-474-5359
Mailing Address - Fax:
Practice Address - Street 1:16749 LITTLE LEAF CT
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-0678
Practice Address - Country:US
Practice Address - Phone:405-474-5359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-06
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2993101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health