Individual
LUCAS TYLER LESLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
1 RICHMOND SQ, PROVIDENCE, RI 02906-5139
(401) 785-0040
Mailing address
24 CORLISS ST UNIT 41727, PROVIDENCE, RI 02940-7840
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
014067
NY
101YM0800X
Mental Health Counselor
Primary
MHC01566
RI
Other
Enumeration date
10/04/2021
Last updated
09/23/2024
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