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General NPI Number Information
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NPI Number | 1447747001
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Entity Type | Individual
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Provider Name | LESLIE JO LINTNER CPSS
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Gender | Female
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Dates
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Enumeration Date | 04/19/2018
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Last Update Date | 03/12/2020
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Provider Practice Location Address
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Address Line | 320 CENTRAL AVE STE 304
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City | COOS BAY
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State | OR
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Zip | 97420-2241
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Country | US
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Telephone | 541-336-7640
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Fax |
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Provider Business Mailing Address
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Address Line | 2670 SHERIDAN AVE
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City | NORTH BEND
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State | OR
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Zip | 97459-3204
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Country | US
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Telephone | 541-808-5206
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19-QMHPC-00546
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License Number State | OR
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