Healthcare Provider Details

I. General information

NPI: 1144894163
Provider Name (Legal Business Name): LESLIE OLIVIER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 08/22/2022
Certification Date: 08/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7197 US HIGHWAY 61 S
SAINT FRANCISVILLE LA
70775
US

IV. Provider business mailing address

7654 HIGHWAY 421
SAINT FRANCISVILLE LA
70775
US

V. Phone/Fax

Practice location:
  • Phone: 814-791-5253
  • Fax: 844-996-1366
Mailing address:
  • Phone: 225-892-2640
  • Fax: 844-996-1366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9077
License Number StateLA
# 6
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: