Provider Demographics
NPI:1871473017
Name:SUMMEY, LESLIE TY (MIN)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:TY
Last Name:SUMMEY
Suffix:
Gender:M
Credentials:MIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 LCR 735
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:TX
Mailing Address - Zip Code:76687-2219
Mailing Address - Country:US
Mailing Address - Phone:361-777-6923
Mailing Address - Fax:
Practice Address - Street 1:206 LCR 735
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:TX
Practice Address - Zip Code:76687-2219
Practice Address - Country:US
Practice Address - Phone:361-777-6923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty