Provider Demographics
NPI:1194717546
Name:STERLING, LESLIE MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:MARIE
Last Name:STERLING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1838
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MT
Mailing Address - Zip Code:59917-1838
Mailing Address - Country:US
Mailing Address - Phone:303-909-1573
Mailing Address - Fax:
Practice Address - Street 1:421 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:LIBBY
Practice Address - State:MT
Practice Address - Zip Code:59923-2039
Practice Address - Country:US
Practice Address - Phone:303-909-1573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9919581041C0700X
MT228361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO46319Medicare ID - Type Unspecified
S60573Medicare UPIN
CO800013882OtherRAILROAD MEDICARE