| Leslie T Herhold Lcsw Llc | |
|
232 Professional Ct Ste A Gulf Shores AL 36542-3523 | |
| (251) 202-9003 | |
| Not Available |
| Full Name | Leslie T Herhold Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 232 Professional Ct Ste A, Gulf Shores, Alabama |
| Authorized Official Name and Position | Leslie T Herhold (OWNER) |
| Authorized Official Contact | 3378494502 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leslie T Herhold Lcsw Llc 370 Apollo Ave Gulf Shores AL 36542-2899 Ph: (337) 849-4502 | Leslie T Herhold Lcsw Llc 232 Professional Ct Ste A Gulf Shores AL 36542-3523 Ph: (251) 202-9003 |
| NPI Number | 1932687589 |
|---|---|
| Provider Enumeration Date | 08/04/2018 |
| Last Update Date | 01/30/2024 |
| Certification Date | 01/30/2024 |
| Medicare PECOS PAC ID | 1456601806 |
|---|---|
| Medicare Enrollment ID | O20210831000038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932687589 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Leslie Theriot Herhold |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730425687 PECOS PAC ID: 2769732114 Enrollment ID: I20210831000070 |
| Provider Name | Hope Elaine Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205431517 PECOS PAC ID: 3678929742 Enrollment ID: I20231025002582 |
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