Provider Demographics
NPI:1427447069
Name:WHITE, LESHANA (LPCA, LCASA)
Entity type:Individual
Prefix:
First Name:LESHANA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPCA, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9700 RESEARCH DR
Mailing Address - Street 2:SUITE 122
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-8552
Mailing Address - Country:US
Mailing Address - Phone:704-405-4265
Mailing Address - Fax:704-405-4262
Practice Address - Street 1:9700 RESEARCH DR
Practice Address - Street 2:SUITE 122
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-8552
Practice Address - Country:US
Practice Address - Phone:704-405-4265
Practice Address - Fax:704-405-4262
Is Sole Proprietor?:No
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10084101Y00000X
NC20869101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)