MEDICARE: DR. LESLIE JO KACSIR PSYD

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	103T00000X	Psychologist	0810004011	VA

General Provider Information

NPI Number	:	1467348748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLIE JO KACSIR PSYD

Provider Business Mailing Address
First Line	:	PO BOX 26
Second Line	:
City	:	STEPHENS CITY
State	:	VA
Zip	:	22655-0026
Country	:	US
Telephone Number	:	540-550-4242
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 26
Second Line	:
City	:	STEPHENS CITY
State	:	VA
Zip	:	22655-0026
Country	:	US
Telephone Number	:	540-550-4242
Fax Number	:

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

Provider Enumeration Date	:	06/14/2025
Last Update Date	:	06/14/2025

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