Provider Demographics
NPI:1801336557
Name:LESLIE WRIGHT COUNSELING, LLC
Entity type:Organization
Organization Name:LESLIE WRIGHT COUNSELING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:479-430-3526
Mailing Address - Street 1:641 HIGHWAY 71 N
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ALMA
Mailing Address - State:AR
Mailing Address - Zip Code:72921-5107
Mailing Address - Country:US
Mailing Address - Phone:479-430-3526
Mailing Address - Fax:
Practice Address - Street 1:641 HIGHWAY 71 N
Practice Address - Street 2:SUITE 5
Practice Address - City:ALMA
Practice Address - State:AR
Practice Address - Zip Code:72921-5107
Practice Address - Country:US
Practice Address - Phone:479-430-3526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1512138101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty