Provider Demographics
NPI:1982254520
Name:NOBLE, LESLIE LAINE (LPC-S)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:LAINE
Last Name:NOBLE
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 CUSTER PKWY APT 1224
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-1068
Mailing Address - Country:US
Mailing Address - Phone:972-998-2952
Mailing Address - Fax:
Practice Address - Street 1:3650 CUSTER PKWY APT 1224
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-1068
Practice Address - Country:US
Practice Address - Phone:972-998-2952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15503101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional