Provider Demographics
NPI:1972354017
Name:STOCKWELL, LESLI (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:LESLI
Middle Name:
Last Name:STOCKWELL
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 JULIE RIVERS DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3144
Mailing Address - Country:US
Mailing Address - Phone:409-241-5630
Mailing Address - Fax:
Practice Address - Street 1:402 JULIE RIVERS DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3144
Practice Address - Country:US
Practice Address - Phone:409-241-5630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91315101YM0800X
101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional