Individual provider Active NPI

Cynthia K. Leslie, LBSW, MA,

  • Mental Health Counselor
  • Fort Gratiot, MI
National Provider Identifier
1710996582
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401006881 Issued in MI
Practice address
3847 Pine Grove Ave Ste a
Fort Gratiot, MI 48059-4265
Phone
(810) 966-3731
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401006881 MI Primary
Social Worker 104100000X 6802033987 MI

Addresses

Primary practice location

3847 Pine Grove Ave Ste a
Fort Gratiot, MI 48059-4265

Mailing address

3148 Wexford Cir
Port Huron, MI 48060-7792
Phone (810) 966-3731

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6401006881MIMDMental Health Counselor
6802033987MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1710996582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3148 WEXFORD CIR",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480607792",
            "telephone_number": "810-966-3731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3847 PINE GROVE AVE STE A",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594265",
            "telephone_number": "810-966-3731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESLIE",
        "first_name": "CYNTHIA",
        "middle_name": "K.",
        "name_prefix": "Mrs.",
        "credential": "LBSW, MA,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401006881",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802033987",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gratiot, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.