Healthcare Provider Details

I. General information

NPI: 1992440937
Provider Name (Legal Business Name): LESLIE A LILES MCAP, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 LOCUST ST
CONNELLY SPRINGS NC
28612-8007
US

IV. Provider business mailing address

329 SANFORD DR
MORGANTON NC
28655-2555
US

V. Phone/Fax

Practice location:
  • Phone: 828-582-9957
  • Fax:
Mailing address:
  • Phone: 828-475-6559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberMCAP100501
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCADC-31570
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: