Provider Demographics
NPI:1962619056
Name:WORKMAN, LESLEY (BA)
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 81 BOX 42
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:WV
Mailing Address - Zip Code:25938-9403
Mailing Address - Country:US
Mailing Address - Phone:304-658-3202
Mailing Address - Fax:
Practice Address - Street 1:175 PHILPOT LANE
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:WV
Practice Address - Zip Code:25813
Practice Address - Country:US
Practice Address - Phone:304-254-9262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)