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NPI Code Detail

MEDICARE: DR. LESLIE SHERLIN PHD, MAC

MEDICARE: DR. LESLIE SHERLIN PHD, MAC
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
1101Y00000XCounselor22998AZ
2101YM0800XMental Health Counselor22998AZ
3101YP2500XProfessional Counselor22998AZ

General Provider Information

NPI Number : 1821627134
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LESLIE SHERLIN PHD, MAC
Provider Business Mailing Address
First Line : 3009 E HUBER ST
Second Line :
City : MESA
State : AZ
Zip : 85213-4234
Country : US
Telephone Number : 480-389-6971
Fax Number :
Provider Business Practice Location Address
First Line : 7272 E INDIAN SCHOOL RD STE 540
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-3996
Country : US
Telephone Number : 480-389-6971
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2020
Last Update Date : 06/05/2024

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