Provider Demographics
NPI:1790090645
Name:KATZ, LESLIE ALICE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ALICE
Last Name:KATZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 ISBELL RD
Mailing Address - Street 2:SUITE 380
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-4967
Mailing Address - Country:US
Mailing Address - Phone:775-348-5800
Mailing Address - Fax:775-827-0791
Practice Address - Street 1:639 ISBELL RD
Practice Address - Street 2:SUITE 380
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4967
Practice Address - Country:US
Practice Address - Phone:775-348-5800
Practice Address - Fax:775-827-0791
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5829 - C101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1790090645Medicaid
NV1790090645Medicaid