Brockman, Leslie Richard
Brockman, Leslie Richard is an individual health care provider with primary practice located at 5801 Curzon Ave Suite 2B, Fort Worth TX 76107-5800. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Brockman, Leslie Richard can be contacted via phone (817) 377-0808.Contact Information
Primary practice address
5801 Curzon Ave Suite 2B
Fort Worth TX 76107-5800
Phone: (817) 377-0808
Fax: (817) 377-0836
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 3152 | Texas |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 8753 | Texas |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 10754 | Texas |
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 614 | Texas |
Profile Details
| NPI number | 1255404257 |
|---|---|
| LBN Legal business name | Brockman, Leslie Richard |
| Credentials | LCSW, LPC, LMFT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 16th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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