Provider Demographics
NPI:1225825623
Name:LAMBERT, LESLIE MARIE (LCDC-I)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:MARIE
Last Name:LAMBERT
Suffix:
Gender:
Credentials:LCDC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14101 W US HIGHWAY 290 STE 600
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-9343
Mailing Address - Country:US
Mailing Address - Phone:512-826-7847
Mailing Address - Fax:
Practice Address - Street 1:14101 W US HIGHWAY 290 STE 600
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-9343
Practice Address - Country:US
Practice Address - Phone:512-826-7847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61280101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional