MEDICARE: MS. DEBORAH A LEIGHTON LCSW, LCAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	370	NC
2	1041C0700X	Clinical Social Worker	C003919	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427185909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH A LEIGHTON LCSW, LCAS

Provider Business Mailing Address
First Line	:	6317 SOUTH BEND LANE
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-4659
Country	:	US
Telephone Number	:	704-814-9850
Fax Number	:	704-814-9850

Provider Business Practice Location Address
First Line	:	5200 PARK RD
Second Line	:	SUITE 200-C
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-3650
Country	:	US
Telephone Number	:	704-814-9850
Fax Number	:	704-631-4578

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	10/24/2015

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