Provider Demographics
NPI:1366534802
Name:LOWER, LESLIE SHERRONE (LCSW)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:SHERRONE
Last Name:LOWER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LEE
Other - Middle Name:SHERRONE
Other - Last Name:TRUTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSCSW
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANA
Mailing Address - State:TN
Mailing Address - Zip Code:37037-0037
Mailing Address - Country:US
Mailing Address - Phone:615-603-9057
Mailing Address - Fax:615-625-2976
Practice Address - Street 1:239 VETERANS PARKWAY
Practice Address - Street 2:SUITE A
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-6439
Practice Address - Country:US
Practice Address - Phone:615-603-9057
Practice Address - Fax:615-625-2976
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2020-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS39671041C0700X
TN60081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ006362Medicaid
TN006936001Medicare PIN