Provider Demographics
NPI:1164687000
Name:BLEY, LESLIE FISHER (LPC-S)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:FISHER
Last Name:BLEY
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:CATHERINE
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4220 MONTEREY OAKS BLVD STE 322
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-1170
Mailing Address - Country:US
Mailing Address - Phone:314-497-7681
Mailing Address - Fax:
Practice Address - Street 1:4220 MONTEREY OAKS BLVD STE 322
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-1170
Practice Address - Country:US
Practice Address - Phone:314-497-7681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004037087101Y00000X
TX75462101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2004037087OtherLPC LICENSE
MO2004037087OtherPLPC LICENSE
TX75462OtherLPC-S LICENSE