Kristina Marie Leslie, LMFT-170

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT-170 Issued in WY

Practice address

3907 Chippewa Ave
Gillette, WY 82718-6674

Phone

(949) 922-3043

Fax

(307) 363-4807

NPI assigned

Aug 2, 2010

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kristina Marie Dorman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Powder River Counseling and Wellness

  • Professional Counselor
  • Gillette, WY
  • NPI 1114854924
  NPD Authorized official
• Powder River Behavior Consultation, LLC

  • Behavior Analyst
  • Gillette, WY
  • NPI 1336526979
  Authorized official Same address or phone

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1245544204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3907 CHIPPEWA AVE",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827186674",
            "telephone_number": "307-682-3747",
            "fax_number": "307-682-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3907 CHIPPEWA AVE",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827186674",
            "telephone_number": "949-922-3043",
            "fax_number": "307-363-4807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1430 Wilkins Cir",
            "address_purpose": "LOCATION",
            "city": "Casper",
            "state": "WY",
            "postal_code": "826011336",
            "country_code": "US",
            "telephone_number": "307-237-9583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 E 4th St Ste 12",
            "address_purpose": "LOCATION",
            "city": "Gillette",
            "state": "WY",
            "postal_code": "827164061",
            "country_code": "US",
            "telephone_number": "307-682-3747",
            "fax_number": "307-682-3748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 E 4th St Ste 12",
            "address_purpose": "LOCATION",
            "city": "Gillette",
            "state": "WY",
            "postal_code": "827164061",
            "country_code": "US",
            "telephone_number": "307-682-3747",
            "fax_number": "307-682-3748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LESLIE",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "credential": "LMFT-170",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WY",
            "license": "LMFT-170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "DORMAN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Landon Ledingham, DMD
• Sarah Leger-Hayworth, LPC
• Jodi Lehman, NCSP
• Paul A Lehman, PPC
• Cassandra Marie Lenhart Hayes, PPC
• Life Connections, LLC
• Lincare Inc.
• Andrea Agusta Lind, LPC
• Jennifer Albers Linden, MD
• Dylan Lindsay, PA-C

• Marriage & Family Therapist in Gillette, WY
• Providers in Gillette, WY by specialty
• Marriage & Family Therapist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.