Provider Demographics
NPI:1639746605
Name:LEJA LESSLIE, ASHLEY (PHD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:LEJA LESSLIE
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 WAUKEGAN RD STE 315
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-2743
Mailing Address - Country:US
Mailing Address - Phone:847-272-2484
Mailing Address - Fax:
Practice Address - Street 1:191 WAUKEGAN RD STE 315
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-2743
Practice Address - Country:US
Practice Address - Phone:847-272-2484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.010051103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty