Provider Demographics
NPI:1548972854
Name:COFFEY, LEIGH MANUEL (LCMHC, LCAS)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:MANUEL
Last Name:COFFEY
Suffix:
Gender:F
Credentials:LCMHC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 NORTH LN
Mailing Address - Street 2:
Mailing Address - City:SWANNANOA
Mailing Address - State:NC
Mailing Address - Zip Code:28778-2048
Mailing Address - Country:US
Mailing Address - Phone:339-203-6460
Mailing Address - Fax:
Practice Address - Street 1:124 NORTH LN
Practice Address - Street 2:
Practice Address - City:SWANNANOA
Practice Address - State:NC
Practice Address - Zip Code:28778-2048
Practice Address - Country:US
Practice Address - Phone:339-203-6460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-2944101YA0400X
NC9656101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)