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General NPI Number Information
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NPI Number | 1285890707
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Entity Type | Individual
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Provider Name | LESLIE JANE EASTERLY MA, LPC, LMHP
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Gender | Female
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Dates
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Enumeration Date | 08/04/2008
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Last Update Date | 11/02/2009
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Provider Practice Location Address
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Address Line | 2245 ILLINOIS ST
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City | SIDNEY
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State | NE
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Zip | 69162-1440
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Country | US
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Telephone | 308-254-1114
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Fax | 308-254-1114
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Provider Business Mailing Address
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Address Line | 2245 ILLINOIS ST
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City | SIDNEY
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State | NE
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Zip | 69162-1440
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Country | US
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Telephone | 308-254-1114
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Fax | 308-254-1114
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3036
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License Number State | NE
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