Provider Demographics
NPI:1447891569
Name:LARTEY, LESLIE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:LARTEY
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8767 SEMINOLE TRL STE 101
Mailing Address - Street 2:
Mailing Address - City:RUCKERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22968-3494
Mailing Address - Country:US
Mailing Address - Phone:434-990-1744
Mailing Address - Fax:434-939-9401
Practice Address - Street 1:8767 SEMINOLE TRL STE 101
Practice Address - Street 2:
Practice Address - City:RUCKERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22968-3494
Practice Address - Country:US
Practice Address - Phone:434-990-1744
Practice Address - Fax:434-939-9401
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001260292163WN0300X
VA0024178397363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WN0300XNursing Service ProvidersRegistered NurseNephrology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner