Provider Demographics
NPI:1790803062
Name:ASKIN, LESLIE DANNETTE (BS CACD INTERN)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:DANNETTE
Last Name:ASKIN
Suffix:
Gender:F
Credentials:BS CACD INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 W CHARLESTON BLVD
Mailing Address - Street 2:215
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2325
Mailing Address - Country:US
Mailing Address - Phone:702-671-2355
Mailing Address - Fax:702-382-5388
Practice Address - Street 1:6375 W CHARLESTON BLVD
Practice Address - Street 2:STE A-172
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1139
Practice Address - Country:US
Practice Address - Phone:702-877-0684
Practice Address - Fax:702-877-2108
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01014-1101Y00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV01014-1OtherCADC INTERN LICENSE
NVWQBHVMedicare ID - Type UnspecifiedGROUP MEDICIARE