Healthcare Provider Details

I. General information

NPI: 1760713903
Provider Name (Legal Business Name): LESLIE HAYMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LESLIE PATTERSON LCSW

II. Dates (important events)

Enumeration Date: 01/28/2010
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 DEANNE AVE
NEWCASTLE WY
82701-2936
US

IV. Provider business mailing address

1876 S SHERIDAN AVE
SHERIDAN WY
82801-6136
US

V. Phone/Fax

Practice location:
  • Phone: 307-746-4456
  • Fax: 307-746-4470
Mailing address:
  • Phone: 307-672-0475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-1386
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: