Provider Demographics
NPI:1922134626
Name:MORELAND, LESLIE (LMHC)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:MORELAND
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:PO BOX 1719
Mailing Address - Street 2:86B ROUTE 6A
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-1719
Mailing Address - Country:US
Mailing Address - Phone:508-833-0269
Mailing Address - Fax:508-833-1467
Practice Address - Street 1:86B ROUTE 6A
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563-1719
Practice Address - Country:US
Practice Address - Phone:508-833-0269
Practice Address - Fax:508-833-1467
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4532101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health