Provider Demographics
NPI:1386073658
Name:KOVALSKI, LESLIE ANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:ANN
Last Name:KOVALSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2698 BURWYN HILLS DRIVE
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:MI
Mailing Address - Zip Code:49286
Mailing Address - Country:US
Mailing Address - Phone:248-709-5534
Mailing Address - Fax:
Practice Address - Street 1:2698 BURWYN HILLS DRIVE
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286
Practice Address - Country:US
Practice Address - Phone:248-709-5534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009753101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional