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General NPI Number Information
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NPI Number | 1366030777
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Entity Type | Individual
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Provider Name | LESLIE DAWN FREE LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/02/2021
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 72 SOMERSET HILLS CT
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City | SAINT CHARLES
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State | MO
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Zip | 63303-7316
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Country | US
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Telephone | 901-633-3657
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Fax |
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Provider Business Mailing Address
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Address Line | 72 SOMERSET HILLS CT
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City | SAINT CHARLES
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State | MO
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Zip | 63303-7316
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Country | US
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Telephone | 901-633-3657
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 108725
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6913
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2024038496
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License Number State | MO
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