Basic Information
| Provider Information | |||||||||
| NPI: | 1740955350 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LESLEY J NORRIS LMHC LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 51 S MAIN AVE STE 304 | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337653937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275600366 | ||||||||
| FaxNumber: | 7272879302 | ||||||||
| Practice Location | |||||||||
| Address1: | 51 S MAIN AVE STE 304 | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337653937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275600366 | ||||||||
| FaxNumber: | 7272879302 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2021 | ||||||||
| LastUpdateDate: | 08/16/2021 | ||||||||
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| AuthorizedOfficialLastName: | NORRIS | ||||||||
| AuthorizedOfficialFirstName: | LESLEY | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | MENTAL HEALTH COUNSELOR | ||||||||
| AuthorizedOfficialTelephone: | 7275600366 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | LMHC | ||||||||
| NPICertificationDate: | 08/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 1205115797 | 01 | FL | NPI | OTHER |