Provider Demographics
NPI:1982889721
Name:LESLIE B. KUERBITZ,MA,LPC,&ASSOCIATES,PLLC
Entity type:Organization
Organization Name:LESLIE B. KUERBITZ,MA,LPC,&ASSOCIATES,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:KUERBITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA,LPC
Authorized Official - Phone:972-272-6161
Mailing Address - Street 1:1226 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-6109
Mailing Address - Country:US
Mailing Address - Phone:972-272-6161
Mailing Address - Fax:972-272-6260
Practice Address - Street 1:1226 W STATE ST
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-6109
Practice Address - Country:US
Practice Address - Phone:972-272-6161
Practice Address - Fax:972-272-6260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15953101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5177LCOtherBLUE CROSS/BLUE SHIELD