Healthcare Provider Details

I. General information

NPI: 1326222076
Provider Name (Legal Business Name): LESLIE ANN THOMAS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2007
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 DAVE WARD DR STE 1900
CONWAY AR
72034-7995
US

IV. Provider business mailing address

3820 DAVE WARD DR STE 1900
CONWAY AR
72034-7995
US

V. Phone/Fax

Practice location:
  • Phone: 479-452-5040
  • Fax: 479-452-5047
Mailing address:
  • Phone: 479-452-5040
  • Fax: 479-452-5047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP1611168
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: