Individual
LESLIE G SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC-MH
Contact information
Practice address
5272 S LEWIS AVE STE 108, TULSA, OK 74105-6563
(918) 984-8900
(918) 948-7927
Mailing address
812 W AUSTIN ST, BROKEN ARROW, OK 74011-3001
(918) 984-8900
(918) 948-7927
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
971
OK
101YM0800X
Mental Health Counselor
Primary
971
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200397730A
—
OK
05
—
200397730B
—
OK
Enumeration date
04/13/2009
Last updated
01/16/2025
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