Provider Demographics
NPI:1700440294
Name:ORR, LESLIE (LMHC, SUDPT)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:ORR
Suffix:
Gender:F
Credentials:LMHC, SUDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3011 196TH ST SW # 1068
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6925
Mailing Address - Country:US
Mailing Address - Phone:206-661-1187
Mailing Address - Fax:
Practice Address - Street 1:2924 151ST PL SW, P102,
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087
Practice Address - Country:US
Practice Address - Phone:206-661-1187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 390200000X
WACO60980465101YA0400X
WALH61308781101YM0800X
WAMC61085633101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program