Provider Demographics
NPI:1134824865
Name:LESKE, SHELBY LYNN (MA, LPCC)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:LYNN
Last Name:LESKE
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3244 23RD AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-5584
Mailing Address - Country:US
Mailing Address - Phone:320-469-2962
Mailing Address - Fax:
Practice Address - Street 1:8550 HUDSON BLVD N
Practice Address - Street 2:
Practice Address - City:LAKE ELMO
Practice Address - State:MN
Practice Address - Zip Code:55042-5500
Practice Address - Country:US
Practice Address - Phone:651-254-8580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3773101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health