Smith, Leslie G

Smith, Leslie G is an sole proprietor health care provider with primary practice located at 821 W Austin St , Broken Arrow OK 74011-3002. She recently has 3 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 / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Smith, Leslie G can be contacted via phone (918) 984-8900.

Contact Information

Primary practice address
821 W Austin St Broken Arrow OK 74011-3002
Phone: (918) 984-8900
Fax: (918) 948-7927
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 971 Oklahoma
Behavioral Health & Social Service Providers / Professional 101YP2500X 971 Oklahoma
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 971 Oklahoma

Profile Details

NPI number 1386887982
LBN Legal business name Smith, Leslie G
Credentials LADC-MH
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 13th, 2009
Last updated Jan 19th, 2021 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1386887982 NPPES
Oklahoma MEDICAID 200397730B
Oklahoma MEDICAID 200397730A

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