Provider Demographics
NPI:1871986489
Name:FEHRMAN, LESLIE (LISW-S, LICDC-CS)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:FEHRMAN
Suffix:
Gender:F
Credentials:LISW-S, LICDC-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-1612
Mailing Address - Country:US
Mailing Address - Phone:740-291-3737
Mailing Address - Fax:833-805-3653
Practice Address - Street 1:550 MAIN ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-1612
Practice Address - Country:US
Practice Address - Phone:740-291-3737
Practice Address - Fax:833-805-3653
Is Sole Proprietor?:No
Enumeration Date:2015-03-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLICDC.161458101YA0400X
OHS1500559-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)