Individual provider Active NPI

Leslie Watland

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1063259471
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1901 N Clybourn Ave Ste 304
Chicago, IL 60614-6808
Phone
(312) 659-4718
NPI assigned
Jul 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1901 N Clybourn Ave Ste 304
Chicago, IL 60614-6808

Mailing address

1634 W Columbia Ave Apt 3S
Chicago, IL 60626-4166
Phone (708) 997-1081

Other names 1

  • Leslie Watland Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1063259471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 W COLUMBIA AVE APT 3S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606264166",
            "telephone_number": "708-997-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 N CLYBOURN AVE STE 304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606146808",
            "telephone_number": "312-659-4718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATLAND",
        "first_name": "LESLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "WATLAND",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.