Provider Demographics
NPI:1124088596
Name:UTTERBACK, LESLIE JEAN (MSW, LCSW)
Entity type:Individual
Prefix:MISS
First Name:LESLIE
Middle Name:JEAN
Last Name:UTTERBACK
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 TALMADGE CT
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-2919
Mailing Address - Country:US
Mailing Address - Phone:828-206-0717
Mailing Address - Fax:
Practice Address - Street 1:1100 TUNNEL RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2043
Practice Address - Country:US
Practice Address - Phone:828-299-2519
Practice Address - Fax:828-299-5992
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0054271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical