Provider Demographics
NPI:1699119941
Name:HENRY-DUPOUX, LEZLEE (LCSW)
Entity type:Individual
Prefix:
First Name:LEZLEE
Middle Name:
Last Name:HENRY-DUPOUX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB #566 1120 HUFFMAN RD
Mailing Address - Street 2:STE 24
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3516
Mailing Address - Country:US
Mailing Address - Phone:907-215-8153
Mailing Address - Fax:
Practice Address - Street 1:615 E 82ND AVE STE 103
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-3100
Practice Address - Country:US
Practice Address - Phone:907-215-8153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-17
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW611702901041C0700X
101YA0400X
AK106272101YP2500X
NY07991211041C0700X
NY0799121041C0700X
AK1005201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional