Individual
DEREK JAMES MACLEOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCASA, LCMHCA
Contact information
Practice address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(910) 399-3755
(910) 202-9966
Mailing address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(910) 399-3755
(910) 202-9966
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
29298
NC
101YM0800X
Mental Health Counselor
A19203
NC
101YP2500X
Professional Counselor
A19203
NC
Other
Enumeration date
07/31/2023
Last updated
09/08/2023
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