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General NPI Number Information
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NPI Number | 1821627134
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Entity Type | Individual
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Provider Name | LESLIE SHERLIN PHD, MAC
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Gender | Male
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Dates
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Enumeration Date | 04/07/2020
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 7272 E INDIAN SCHOOL RD STE 540
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-3996
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Country | US
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Telephone | 480-389-6971
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Fax |
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Provider Business Mailing Address
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Address Line | 3009 E HUBER ST
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City | MESA
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State | AZ
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Zip | 85213-4234
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Country | US
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Telephone | 480-389-6971
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 22998
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 22998
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 22998
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License Number State | AZ
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