Individual provider Active NPI

Leslie R Justice, DNP, PMHCNS-BC, APRN

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Sumter, SC
National Provider Identifier
1033211321
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
2210 Issued in SC
Practice address
1278 N Lafayette Dr
Sumter, SC 29150-2964
Phone
(803) 774-4500
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 2210 SC Primary

Addresses

Primary practice location

1278 N Lafayette Dr
Sumter, SC 29150-2964

Mailing address

1278 N Lafayette Dr
Sumter, SC 29150-2964
Phone (803) 774-4500

Other identifiers 1

IdentifierTypeStateIssuer
NP1471MedicaidSC

Other names 1

  • Ms. Mary L Dias Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090409000645 SC Practitioner - Certified Clinical Nurse Specialist (CNS) 6103982228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
35638SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: leslie.justice.2@13095.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1033211321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1278 N LAFAYETTE DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502964",
            "telephone_number": "803-774-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1278 N LAFAYETTE DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502964",
            "telephone_number": "803-774-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "LESLIE",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "DNP, PMHCNS-BC, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "SC",
            "license": "2210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1471",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "DIAS",
            "middle_name": "L",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sumter, SC

Sources for this page

Verify at the official NPI Registry.