Healthcare Provider Details

I. General information

NPI: 1386319234
Provider Name (Legal Business Name): LESLIE A. BRAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2021
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W WALNUT ST
COLUMBUS KS
66725-1121
US

IV. Provider business mailing address

201 W WALNUT ST
COLUMBUS KS
66725-1121
US

V. Phone/Fax

Practice location:
  • Phone: 620-429-1860
  • Fax:
Mailing address:
  • Phone: 620-429-1860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number03817
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: