Individual
LEISA KEISHA COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-A, LCAS-A
Contact information
Practice address
75 GROVER PL, CAMERON, NC 28326-6210
(910) 824-3865
Mailing address
75 GROVER PL, CAMERON, NC 28326-6210
(910) 824-3865
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS22226
NC
101YP2500X
Professional Counselor
Primary
A11962
NC
Other
Enumeration date
02/09/2016
Last updated
02/09/2016
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