Provider Demographics
NPI:1063709509
Name:LESLIE A ABBEY, L.L.C.
Entity type:Organization
Organization Name:LESLIE A ABBEY, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABBEY
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:913-262-2950
Mailing Address - Street 1:1900 W 75TH ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-3501
Mailing Address - Country:US
Mailing Address - Phone:913-262-2950
Mailing Address - Fax:913-384-4629
Practice Address - Street 1:1900 W 75TH ST
Practice Address - Street 2:SUITE 120
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-3501
Practice Address - Country:US
Practice Address - Phone:913-262-2950
Practice Address - Fax:913-384-4629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLSCSW1264261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS18026022OtherBLUE CROSS/BLUE SHIELD