Provider Demographics
NPI:1285309757
Name:MASHELLE LESTER LCSW LLC
Entity type:Organization
Organization Name:MASHELLE LESTER LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MASHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LESTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:541-264-0115
Mailing Address - Street 1:1007 NE BITTERBRUSH RD
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-8676
Mailing Address - Country:US
Mailing Address - Phone:154-126-4011
Mailing Address - Fax:
Practice Address - Street 1:1007 NE BITTERBRUSH RD
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-8676
Practice Address - Country:US
Practice Address - Phone:541-264-0115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty