Provider Demographics
NPI:1487988630
Name:BITTNER, LESLEY
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:
Last Name:BITTNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3568 WALLACE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-4446
Mailing Address - Country:US
Mailing Address - Phone:412-559-6063
Mailing Address - Fax:
Practice Address - Street 1:5950 FAIRVIEW RD STE 808
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-2110
Practice Address - Country:US
Practice Address - Phone:980-867-4440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0149371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical