Provider Demographics
NPI:1962702498
Name:MORRISON, LESLIE WILLIAM (MA, LPC)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:WILLIAM
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41954 KENTVALE DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1981
Mailing Address - Country:US
Mailing Address - Phone:586-909-4394
Mailing Address - Fax:
Practice Address - Street 1:888 W BIG BEAVER RD
Practice Address - Street 2:SUITE 1450
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4736
Practice Address - Country:US
Practice Address - Phone:248-244-8644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011072101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional