Provider Demographics
NPI:1194051193
Name:FORRESTER, LESLEE RENE (LPC)
Entity type:Individual
Prefix:
First Name:LESLEE
Middle Name:RENE
Last Name:FORRESTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LESLEE
Other - Middle Name:RENE
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:38740 PROCTOR BLVD
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-8030
Mailing Address - Country:US
Mailing Address - Phone:503-668-5494
Mailing Address - Fax:503-668-6368
Practice Address - Street 1:38740 PROCTOR BLVD
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-8030
Practice Address - Country:US
Practice Address - Phone:503-668-5494
Practice Address - Fax:503-668-6368
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1723101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor