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General NPI Number Information
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NPI Number | 1134504947
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Entity Type | Individual
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Provider Name | LESLIE ROBERTS LPC
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Gender | Female
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Dates
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Enumeration Date | 07/22/2015
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 2928 N MCKEE CIR STE 124
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-3465
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Country | US
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Telephone | 479-200-9696
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Fax | 479-974-4907
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Provider Business Mailing Address
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Address Line | 2928 N MCKEE CIR STE 124
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-3465
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Country | US
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Telephone | 479-200-9696
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Fax | 479-974-4907
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | P1910123
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License Number State | AR
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