Provider Demographics
NPI:1740701697
Name:LLOYD, LESLIE L (LPCC)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:L
Last Name:LLOYD
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:LAURA
Other - Last Name:GLEASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:8212 SHANNON OAK LN
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-1171
Mailing Address - Country:US
Mailing Address - Phone:816-813-1581
Mailing Address - Fax:
Practice Address - Street 1:6615 VALLEY HI DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-7076
Practice Address - Country:US
Practice Address - Phone:916-450-2650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-30
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6440101Y00000X
MO2017022256101YM0800X, 101YP2500X
KS3244101YP2500X
CALPCC9457101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO490043878Medicaid