Individual
LESLIE G OLECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS, LMFT
Contact information
Practice address
9670 E WASHINGTON ST, STE120, INDIANAPOLIS, IN 46229-3032
(317) 890-5700
(317) 890-5717
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
35001274A
IN
364S00000X
Clinical Nurse Specialist
Primary
35001274
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200976370
—
IN
Enumeration date
04/17/2007
Last updated
02/18/2014
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