Lesley Ann Clark
Individual provider Active NPI Behavior Technician · Woodbine, GA
NPI 1003569062 · NPPES record last updated Jan 31, 2022
Key facts
- NPI
- 1003569062
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 408 Bedell Ave
Woodbine, GA 31569-3585 - Phone
- (912) 409-7889
- NPI assigned
- Jan 31, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nurture Behavioral Health and Education Services, LLC | Current |
Accepting new patients |
Locations
1201 Shadowlawn Dr
Ste 112
Saint Marys, GA 31558
Phone (912) 409-7889
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
408 Bedell Ave
Woodbine, GA 31569-3585
Mailing address
1201 Shadowlawn Dr Ste 112
Saint Marys, GA 31558-4074
Other providers in Woodbine, GA
- Joshua Evan Barber
- Lori Bishop
- Amber A Brown
- Teresa Skipper Brown
- Bridgette Buie
- Coastal Community Health Services, Inc.
- Coastal Re-Entry and Veteran'S Coalition, Inc
- Coastal Speech Therapy
- Contemporary Midwifery, LLC
- Marlo Dilorenzo
All providers in Woodbine, GA · Behavior Technician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.