Leslie Ingrid Rheault, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4608066 Issued in OR

Practice address

2191 Canal St
Medford, OR 97501-4338

Phone

(541) 499-1088

NPI assigned

Mar 25, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Leslie Rheault, LPC

  • Community/Behavioral Health Agency
  • Medford, OR
  • NPI 1861927089
  NPD (past) Authorized official
• La Clinica del Valle Family Health Care Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Central Point, OR
  • NPI 1942626700
  NPD (past)

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

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1093014391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 CANAL ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975014338",
            "telephone_number": "541-499-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2191 CANAL ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975014338",
            "telephone_number": "541-499-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHEAULT",
        "first_name": "LESLIE",
        "middle_name": "INGRID",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-25",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C1655",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "4608066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariana Keyasha Reynolds
• Michael Reynolds, DDS
• Susan Reynolds, PT
• Yue Reynolds, FNP
• Brian Rheault, SLP
• Amanda Rhein, LMT
• Rheumatology Clinic LLC
• Rhiannon Theurer LMFT
• Deanna Marie Rhoden, RPH
• Anne Rice

• Mental Health Counselor in Medford, OR
• Providers in Medford, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.