Provider Demographics
NPI:1720379332
Name:COOK, LESLEY (PSYD)
Entity type:Individual
Prefix:DR
First Name:LESLEY
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:LESLEY
Other - Middle Name:CLAIRE
Other - Last Name:WOODS-BRONSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:10901 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716
Mailing Address - Country:US
Mailing Address - Phone:727-437-2870
Mailing Address - Fax:
Practice Address - Street 1:10901 ROOSEVELT BLVD
Practice Address - Street 2:BLDG 2-B, SUITE 800
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716
Practice Address - Country:US
Practice Address - Phone:727-437-2870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-29
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810005049103TC0700X
HI1252103TC0700X
FLPY11869103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical