Provider Demographics
NPI:1447051446
Name:KAGLE, LESLIE
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:KAGLE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W OTIS AVE
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-8713
Mailing Address - Country:US
Mailing Address - Phone:785-825-0541
Mailing Address - Fax:785-825-0062
Practice Address - Street 1:225 W EUCLID AVE
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-8780
Practice Address - Country:US
Practice Address - Phone:785-825-0541
Practice Address - Fax:785-825-0062
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04994-T101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional