Provider Demographics
NPI:1730431008
Name:DELACRUZ, LESLIE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:
Last Name:DELACRUZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 W HUFFAKER LN STE 302
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2091
Mailing Address - Country:US
Mailing Address - Phone:775-233-6789
Mailing Address - Fax:
Practice Address - Street 1:180 W HUFFAKER LN STE 302
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2091
Practice Address - Country:US
Practice Address - Phone:775-233-6789
Practice Address - Fax:775-233-6789
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01305101YM0800X
NVMI-0039106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health