Healthcare Provider Details

I. General information

NPI: 1407160773
Provider Name (Legal Business Name): PATRICIA CORBETT LESSLIE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 CLAWSON PL UNIT 1110
FORT MILL SC
29715-8942
US

IV. Provider business mailing address

128 SUMMERS CREEK CT
MT PLEASANT SC
29464-7944
US

V. Phone/Fax

Practice location:
  • Phone: 843-412-5173
  • Fax:
Mailing address:
  • Phone: 843-412-5173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4973
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: