Provider Demographics
NPI:1396067427
Name:POWERS, LESLIE ANNE (LMFT)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ANNE
Last Name:POWERS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:LESLIE
Other - Middle Name:A
Other - Last Name:POWERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:8 KING PHILIP PATH
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043
Mailing Address - Country:US
Mailing Address - Phone:617-413-6184
Mailing Address - Fax:
Practice Address - Street 1:51 MILL STREET,
Practice Address - Street 2:SUITE 8
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339
Practice Address - Country:US
Practice Address - Phone:781-812-5265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1369106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist