Provider Demographics
NPI:1427279223
Name:LESLYE MOHRMAN COUNSELING INC
Entity type:Organization
Organization Name:LESLYE MOHRMAN COUNSELING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LESLYE
Authorized Official - Middle Name:ELLIOTT
Authorized Official - Last Name:MOHRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:260-402-3900
Mailing Address - Street 1:3009 E STONE LEDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:46750-9584
Mailing Address - Country:US
Mailing Address - Phone:260-402-3900
Mailing Address - Fax:
Practice Address - Street 1:3009 E STONE LEDGE BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:IN
Practice Address - Zip Code:46750-9584
Practice Address - Country:US
Practice Address - Phone:260-402-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000577A305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000173847OtherBCBS PIN NUMBER
IN290878000OtherMAGELLAN PIN NUMBER