Provider Demographics
NPI:1992752190
Name:TERNER, LESLIE SIEBERT (MS, APRN, CS-P, CRS)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:SIEBERT
Last Name:TERNER
Suffix:
Gender:F
Credentials:MS, APRN, CS-P, CRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 HICKORY HILL CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-5807
Mailing Address - Country:US
Mailing Address - Phone:301-461-9427
Mailing Address - Fax:301-871-0886
Practice Address - Street 1:19 HICKORY HILL CT
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-5807
Practice Address - Country:US
Practice Address - Phone:301-461-9427
Practice Address - Fax:301-871-0886
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR070051163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
489331OtherVALUE OPTIONS
MD131502100Medicaid
7490026OtherAETNA
M4010001OtherBLUES
11250710OtherCAQH
170240000OtherMAGELLAN
708595OtherNCPPO
490311Medicare ID - Type Unspecified