Provider Demographics
NPI:1336821222
Name:HARRIS-JOHNSTON, LESLIE R (LMHCA)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:R
Last Name:HARRIS-JOHNSTON
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13129 129TH CT NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3229
Mailing Address - Country:US
Mailing Address - Phone:319-481-2163
Mailing Address - Fax:
Practice Address - Street 1:13129 129TH CT NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3229
Practice Address - Country:US
Practice Address - Phone:319-481-2163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61393908101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health