Individual provider · Type 1 NPI

Leslie As Douglass, LCSW

Mental Health Counselor · Kokomo, IN

NPI number 1710104559 Active

Practice location

322 N Main St
Kokomo, IN 46901-4622

Call (765) 453-8555 Map

Fax (765) 453-8020

Mailing address

6626 E 75th Street, Suite 500
Indianapolis, IN 46250-2890

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X34005269A (IN)

Mental Health Counselor: Definition to come...

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About NPI 1710104559

Leslie As Douglass, LCSW's National Provider Identifier is 1710104559, issued on Apr 20, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Kokomo, IN. The record was last updated on Dec 17, 2018.