Provider Demographics
NPI:1134820996
Name:GARZA, LESLIE (LPCC)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:GARZA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 HOLLOW BROOK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-1443
Mailing Address - Country:US
Mailing Address - Phone:719-249-0984
Mailing Address - Fax:
Practice Address - Street 1:2116 HOLLOW BROOK DR STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1443
Practice Address - Country:US
Practice Address - Phone:098-471-9249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0020267101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor