MEDICARE: TIERRA S LEACH LCMHCA

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	101YM0800X	Mental Health Counselor	A18135	NC

General Provider Information

NPI Number	:	1821927583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIERRA S LEACH LCMHCA

Provider Business Mailing Address
First Line	:	1057 DRESSER CT
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-7323
Country	:	US
Telephone Number	:	984-212-0028
Fax Number	:

Provider Business Practice Location Address
First Line	:	1057 DRESSER CT
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-7323
Country	:	US
Telephone Number	:	910-474-4000
Fax Number	:

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

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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Directions to “ TIERRA S LEACH LCMHCA” Practice Location

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