Provider Demographics
NPI:1194928606
Name:AULD, LESLIE ERIKA (LMSW, ACSW)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ERIKA
Last Name:AULD
Suffix:
Gender:F
Credentials:LMSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4572 S HAGADORN RD
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-5385
Mailing Address - Country:US
Mailing Address - Phone:517-481-2133
Mailing Address - Fax:517-659-5934
Practice Address - Street 1:4572 S HAGADORN RD
Practice Address - Street 2:SUITE 1C
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-5385
Practice Address - Country:US
Practice Address - Phone:517-481-2133
Practice Address - Fax:517-659-5934
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010646811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI3458001Medicare PIN