Provider Demographics
NPI:1427464361
Name:LEACH, CHRISTOPHER JASON (MS NCC LPC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JASON
Last Name:LEACH
Suffix:
Gender:M
Credentials:MS NCC LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 RYMARK CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-2634
Mailing Address - Country:US
Mailing Address - Phone:919-819-6082
Mailing Address - Fax:919-573-0438
Practice Address - Street 1:7330 CHAPEL HILL RD
Practice Address - Street 2:STE 206
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-5042
Practice Address - Country:US
Practice Address - Phone:919-819-6082
Practice Address - Fax:919-573-0438
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-10
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9420101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health