Provider Demographics
NPI:1386081495
Name:GUY, LESLIE (MSW,LCSW)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:
Last Name:GUY
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:
Other - Last Name:CARDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:LOGANSPORT
Mailing Address - State:IN
Mailing Address - Zip Code:46947-1577
Mailing Address - Country:US
Mailing Address - Phone:574-722-5151
Mailing Address - Fax:574-572-2795
Practice Address - Street 1:1000 N BROADWAY STE A
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IN
Practice Address - Zip Code:46970-1070
Practice Address - Country:US
Practice Address - Phone:765-472-1931
Practice Address - Fax:765-472-1945
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34008598A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical