Provider Demographics
NPI:1326796079
Name:LEDBETTER, LESLIE ELIZABETH (LICSW)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:ELIZABETH
Last Name:LEDBETTER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7358 US HIGHWAY 231
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36092-2053
Mailing Address - Country:US
Mailing Address - Phone:334-478-0533
Mailing Address - Fax:
Practice Address - Street 1:7358 US HIGHWAY 231
Practice Address - Street 2:
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36092-2053
Practice Address - Country:US
Practice Address - Phone:334-478-0533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5794G104100000X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker