Provider Demographics
NPI:1972125946
Name:STOCKTON, LESLEY (PHD)
Entity Type:Individual
Prefix:MS
First Name:LESLEY
Middle Name:
Last Name:STOCKTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3837 N DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-2647
Mailing Address - Country:US
Mailing Address - Phone:812-322-5712
Mailing Address - Fax:
Practice Address - Street 1:3837 N DELAWARE ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-2647
Practice Address - Country:US
Practice Address - Phone:812-322-5712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling