Provider Demographics
NPI:1720213903
Name:HERMANN, LESLEY THOMAS (LMSW)
Entity Type:Individual
Prefix:MS
First Name:LESLEY
Middle Name:THOMAS
Last Name:HERMANN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:LESLEY
Other - Middle Name:MEGAN
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:275 CUMBERLAND BND
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1805
Mailing Address - Country:US
Mailing Address - Phone:615-726-0125
Mailing Address - Fax:615-743-1682
Practice Address - Street 1:275 CUMBERLAND BND
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1805
Practice Address - Country:US
Practice Address - Phone:615-726-0125
Practice Address - Fax:615-743-1682
Is Sole Proprietor?:No
Enumeration Date:2009-05-18
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000067031041C0700X
TN54561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical