Provider Demographics
NPI:1669066478
Name:WEIR, LESLEY (LMHC)
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:
Last Name:WEIR
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 1:22 COLUMBIA CIR SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2718
Mailing Address - Country:US
Mailing Address - Phone:832-805-6709
Mailing Address - Fax:
Practice Address - Street 1:22 COLUMBIA CIR SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2718
Practice Address - Country:US
Practice Address - Phone:832-805-6709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61029565101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health