Provider Demographics
NPI:1124824776
Name:LEIGHTY, CARRIE ANN (CADC)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:LEIGHTY
Suffix:
Gender:
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 469
Mailing Address - Street 2:
Mailing Address - City:HEPPNER
Mailing Address - State:OR
Mailing Address - Zip Code:97836-0469
Mailing Address - Country:US
Mailing Address - Phone:541-676-9161
Mailing Address - Fax:541-676-5662
Practice Address - Street 1:211 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-2139
Practice Address - Country:US
Practice Address - Phone:541-278-6330
Practice Address - Fax:541-278-5419
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)