Provider Demographics
NPI:1710350285
Name:KHOURY, LESLIE (LMHC)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:KHOURY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 FALK RD APT P90
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-5491
Mailing Address - Country:US
Mailing Address - Phone:314-307-7152
Mailing Address - Fax:
Practice Address - Street 1:19120 SE 34TH ST STE 201
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-1430
Practice Address - Country:US
Practice Address - Phone:360-803-8272
Practice Address - Fax:253-295-5594
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health