Provider Demographics
NPI:1972016731
Name:BINDER, LESLIE L (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:L
Last Name:BINDER
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 W TRAIL POINT DR
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-7626
Mailing Address - Country:US
Mailing Address - Phone:417-496-9515
Mailing Address - Fax:
Practice Address - Street 1:138 W TRAIL POINT DR
Practice Address - Street 2:
Practice Address - City:NIXA
Practice Address - State:MO
Practice Address - Zip Code:65714-7626
Practice Address - Country:US
Practice Address - Phone:417-496-9515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017039815106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO490064852Medicaid