Provider Demographics
NPI:1881122984
Name:WALTERS, LESLIE JOLENE (LMSW)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:JOLENE
Last Name:WALTERS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 GOLDFINCH RD
Mailing Address - Street 2:
Mailing Address - City:HORTON
Mailing Address - State:KS
Mailing Address - Zip Code:66439-9537
Mailing Address - Country:US
Mailing Address - Phone:785-486-2154
Mailing Address - Fax:785-486-2158
Practice Address - Street 1:1117 GOLDFINCH RD
Practice Address - Street 2:
Practice Address - City:HORTON
Practice Address - State:KS
Practice Address - Zip Code:66439-9537
Practice Address - Country:US
Practice Address - Phone:785-486-2154
Practice Address - Fax:785-486-2158
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10360104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker