Provider Demographics
NPI:1962728352
Name:WILLIAMS, LESLIE (LCSW, CCTP)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 W MARKET ST
Mailing Address - Street 2:STE 2900
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-2954
Mailing Address - Country:US
Mailing Address - Phone:866-434-3255
Mailing Address - Fax:
Practice Address - Street 1:2335 MATTHEWS TOWNSHIP PKWY
Practice Address - Street 2:STE 101
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-2403
Practice Address - Country:US
Practice Address - Phone:866-434-3255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-11
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040072691041C0700X
NCC0067561041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC13604553OtherCIGNA
NC6007532Medicaid
NC928979OtherAVAILITY
NC000816420001OtherUHC - OPTUM
NC17431OtherBLUE CROSS BLUE SHIELD OF NORTH CAROLINA
NC5092840OtherAETNA