MEDICARE: MR. LESLIE LEBRAD AUSTIN LCDC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	9505	TX
2	101YM0800X	Mental Health Counselor	74025	TX

General Provider Information

NPI Number	:	1265679435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LESLIE LEBRAD AUSTIN LCDC

Provider Business Mailing Address
First Line	:	4654 HIGHWAY 6 N STE 301
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-2879
Country	:	US
Telephone Number	:	281-463-9292
Fax Number	:	281-463-9295

Provider Business Practice Location Address
First Line	:	4654 HIGHWAY 6 N STE 301
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-2879
Country	:	US
Telephone Number	:	281-463-9292
Fax Number	:	281-463-9295

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2009
Last Update Date	:	04/18/2024

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