Healthcare Provider Details

I. General information

NPI: 1669311387
Provider Name (Legal Business Name): LESLIE ANN CALDWELL LPCA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BELMONT AVE
SOMERSET KY
42501-2419
US

IV. Provider business mailing address

200 BELMONT AVE
SOMERSET KY
42501-2419
US

V. Phone/Fax

Practice location:
  • Phone: 606-687-2038
  • Fax: 600-200-3654
Mailing address:
  • Phone: 606-687-2038
  • Fax: 606-200-3654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number299512
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: