Healthcare Provider Details

I. General information

NPI: 1336235399
Provider Name (Legal Business Name): LESLIE LEVINE & ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6305 CHERRY TREE LN NE
ATLANTA GA
30328-3314
US

IV. Provider business mailing address

6305 CHERRY TREE LN NE
ATLANTA GA
30328-3314
US

V. Phone/Fax

Practice location:
  • Phone: 678-641-9400
  • Fax: 678-623-5577
Mailing address:
  • Phone: 678-641-9400
  • Fax: 678-623-5577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: LESLIE LEVINE
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: CCC-SLP
Phone: 678-641-9400