Provider Demographics
NPI:1871045625
Name:SALISBURY, LESLEY COLLEEN (LMHC)
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:COLLEEN
Last Name:SALISBURY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 N MAIN ST STE 10
Mailing Address - Street 2:
Mailing Address - City:E LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-1837
Mailing Address - Country:US
Mailing Address - Phone:774-452-6065
Mailing Address - Fax:
Practice Address - Street 1:264 N MAIN ST STE 10
Practice Address - Street 2:
Practice Address - City:E LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-1837
Practice Address - Country:US
Practice Address - Phone:413-657-4350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-27
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC10001707101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health