Provider Demographics
NPI:1730367053
Name:ESLINGER, LELAND EUGENE (LCPC)
Entity type:Individual
Prefix:MR
First Name:LELAND
Middle Name:EUGENE
Last Name:ESLINGER
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1284 E 16TH ST
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-5463
Mailing Address - Country:US
Mailing Address - Phone:208-522-9331
Mailing Address - Fax:208-522-9331
Practice Address - Street 1:1284 E 16TH ST
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-5463
Practice Address - Country:US
Practice Address - Phone:208-522-9331
Practice Address - Fax:208-522-9331
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-150101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional