Provider Demographics
NPI:1982056875
Name:CONTOS, LESLIE (PHD, LCPC, NCC,CCMHC)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:
Last Name:CONTOS
Suffix:
Gender:F
Credentials:PHD, LCPC, NCC,CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 S RAVINE WAY
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83687-3626
Mailing Address - Country:US
Mailing Address - Phone:208-505-8196
Mailing Address - Fax:
Practice Address - Street 1:4696 W OVERLAND RD STE 172
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-2878
Practice Address - Country:US
Practice Address - Phone:208-505-8196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180011943101YM0800X
IDLCPC-8277101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health