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General NPI Number Information
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NPI Number | 1609022029
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Entity Type | Individual
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Provider Name | JESSICA WILEY LESLIE LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 625 E KALISTE SALOOM RD STE 400N
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City | LAFAYETTE
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State | LA
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Zip | 70508-2540
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Country | US
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Telephone | 337-504-3802
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Fax | 800-398-9547
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Provider Business Mailing Address
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Address Line | 126 DARCY DR
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City | ARCHER LODGE
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State | NC
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Zip | 27527-7309
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Country | US
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Telephone | 337-349-9662
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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 | 103893
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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 | 8570
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License Number State | LA
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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 | SW15676
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC17354
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License Number State | ME
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 20261
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License Number State | AZ
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C008048
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License Number State | NC
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