Provider Demographics
NPI:1396080883
Name:ISAAK, LESLEY CRANDALL (LPC)
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:CRANDALL
Last Name:ISAAK
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 1:301 E BETHANY HOME RD STE C296
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1271
Mailing Address - Country:US
Mailing Address - Phone:602-999-2069
Mailing Address - Fax:
Practice Address - Street 1:301 E BETHANY HOME RD STE C296
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1271
Practice Address - Country:US
Practice Address - Phone:602-999-2069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-16031101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health