Provider Demographics
NPI:1669861936
Name:DELANEY, LESHA (LCPC)
Entity Type:Individual
Prefix:
First Name:LESHA
Middle Name:
Last Name:DELANEY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NEWKIRK
Mailing Address - State:OK
Mailing Address - Zip Code:74647-1500
Mailing Address - Country:US
Mailing Address - Phone:580-362-6863
Mailing Address - Fax:580-992-0001
Practice Address - Street 1:8385 W LA MADRE WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4707
Practice Address - Country:US
Practice Address - Phone:580-761-6295
Practice Address - Fax:405-358-2632
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-09
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
NVCP5042101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1669861936Medicaid