Provider Demographics
NPI:1306122502
Name:ATHERTON, WILLIAM LEIGH (PHD, LPC, LCAS, CCS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LEIGH
Last Name:ATHERTON
Suffix:
Gender:M
Credentials:PHD, LPC, LCAS, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2867 LITTLE GEM CIR
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-7910
Mailing Address - Country:US
Mailing Address - Phone:857-498-2512
Mailing Address - Fax:
Practice Address - Street 1:313 CLIFTON ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5008
Practice Address - Country:US
Practice Address - Phone:857-498-2512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1567101YA0400X
NC7831101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional