Healthcare Provider Details

I. General information

NPI: 1679868814
Provider Name (Legal Business Name): LESLEY N MANSON WHNP-BC, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2011
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2365 INNIS RD
COLUMBUS OH
43224-3730
US

IV. Provider business mailing address

330 NUTMEG CT
CIRCLEVILLE OH
43113-1194
US

V. Phone/Fax

Practice location:
  • Phone: 614-235-5555
  • Fax: 614-536-1994
Mailing address:
  • Phone: 740-497-1267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN.CNP.12584
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.12584
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: