Provider Demographics
NPI:1629959358
Name:LESLIE, LAURA BAFFORD (LCSW, PHD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:BAFFORD
Last Name:LESLIE
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1914 E SIDE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-4308
Mailing Address - Country:US
Mailing Address - Phone:203-258-4526
Mailing Address - Fax:
Practice Address - Street 1:1914 E SIDE DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-4308
Practice Address - Country:US
Practice Address - Phone:203-258-4526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX578141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty