Leisa Keisha Cook, LPC-A, LCAS-A

Individual provider Active NPI Professional Counselor · Cameron, NC

NPI 1255799920 · NPPES record last updated Feb 9, 2016

Key facts

NPI
1255799920
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
A11962 (NC)
Practice address
75 Grover PL
Cameron, NC 28326-6210
Phone
(910) 824-3865
NPI assigned
Feb 9, 2016
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LCAS22226NCMDAddiction (Substance Use Disorder) Counselor
A11962NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Benevolent Counseling, PLLC Professional Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS22226 NC
Professional Counselor 101YP2500X A11962 NC Yes

Addresses

Primary practice location

75 Grover PL
Cameron, NC 28326-6210

Mailing address

75 Grover PL
Cameron, NC 28326-6210
Phone (910) 824-3865

Other providers in Cameron, NC

All providers in Cameron, NC · Professional Counselor in North Carolina

Sources for this page

Verify at the official NPI Registry.