Healthcare Provider Details

I. General information

NPI: 1528808250
Provider Name (Legal Business Name): LESLIE HOLLAND MSRC, LMHC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 NORTHPOINTE CIR STE 301
SEVEN FIELDS PA
16046-7867
US

IV. Provider business mailing address

606 LOCUST PL
SEWICKLEY PA
15143-1515
US

V. Phone/Fax

Practice location:
  • Phone: 412-322-2129
  • Fax:
Mailing address:
  • Phone: 239-269-6619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number016725
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: