LESLIE PHILLOS DUCKETT


Address: 208 River Park North Dr, Woodstock, GA 30188-7834
Phone: 4043079071

LESLIE PHILLOS DUCKETT (NPI# 1336755537) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336755537
Entity Type Individual
Full Name LESLIE PHILLOS DUCKETT
Credential LPC, NCC
Practice Address 208 River Park North Dr
Woodstock
GA 30188-7834
Mailing Address 6750 Polo Dr
Cumming
GA 30040-5725
Practice Telephone 4043079071
Mailing Telephone 4044035690
Enumeration Date 2020-09-22
Last Update Date 2020-09-22
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional
LPC010687 GA Behavioral Health & Social Service Providers

Office Location

Street Address 208 RIVER PARK NORTH DR
City WOODSTOCK
State GA
Zip Code 30188-7834

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1275093437 Rebekah Ruth Tchouta Social Worker 5166 Shotwell St, Woodstock, GA 30188 2019-03-23
1205395829 Angela M Graves Behavior Technician 3229 S Cherokee Ln Ste 1400, Woodstock, GA 30188 2019-03-13
1396233391 Costco Wholesale Corporation Hearing Aid Equipment 113 Lincoln Street, Woodstock, GA 30188 2018-04-25
1659878080 Alexis K. Brown Counselor 3380 Trickum Rd., Bldg 700, Woodstock, GA 30188 2018-04-11
1427555440 Lisa Marie Anthony Specialist/Technologist 400 Arnold Mill Rd, Woodstock, GA 30188 2018-04-06
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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1134736788 Lana Mcnair Counselor 970 Woodstock Pkwy Ste 210, Woodstock, GA 30188-4869 2020-09-28
1871064758 Nazila Aghazadeh Counselor 237 Colony Center Dr, Woodstock, GA 30188-4697 2018-12-17
1437638954 Atlanta Counseling Insight, LLC Counselor 115 Piedmont Ln, Woodstock, GA 30189-7051 2018-08-07
1659878080 Alexis K. Brown Counselor 3380 Trickum Rd., Bldg 700, Woodstock, GA 30188 2018-04-11
1821478009 Georgia Counseling Center Inc Counselor 335 Parkway 575 Ste 301, Woodstock, GA 30188-6433 2015-06-03
1952781239 Barry James Bouillion Jr. Counselor 3380 Trickum Rd Bldg 700, Woodstock, GA 30188-3680 2015-06-02
1952790727 Tiffanie Wigstrom Williams Counselor 3380 Trickum Rd., Building 1000, Suite 102, Woodstock, GA 30188 2015-01-16
1952710337 Grounding Flight Counselor 136 Pioneer Dr, Woodstock, GA 30188-4522 2014-08-11
1790111631 Richard Lee Mccoy Counselor 134 Cass St Ste 3, Woodstock, IL 60098-3208 2013-09-24
1164767257 Marcie J Sacks Botto Counselor 2030 N Seminary Ave, Woodstock, IL 60098-2626 2012-11-30
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Competitor

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City WOODSTOCK
Zip Code 30188

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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