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General NPI Number Information
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NPI Number | 1023550548
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Entity Type | Organization
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Legal Business Name | LESLIE THOMAS, M.S., LPC
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Dates
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Enumeration Date | 11/15/2016
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Last Update Date | 11/15/2016
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Provider Practice Location Address
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Address Line | 1422 CALDWELL ST SUITE H
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City | CONWAY
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State | AR
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Zip | 72034-5319
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Country | US
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Telephone | 501-499-9231
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Fax | 501-904-4373
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Provider Business Mailing Address
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Address Line | 3900 DAVE WARD DR STE 1900, PMB#327
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City | CONWAY
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State | AR
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Zip | 72034-5583
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Country | US
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Telephone | 501-499-9231
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Fax | 501-904-4374
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Authorized Official
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Title or Position | OWNER/LPC
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Name | MRS. LESLIE ANN THOMAS
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Credential | M.S, LPC
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Telephone | 501-499-9231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | P1611168
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License Number State | AR
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