Healthcare Provider Details
I. General information
NPI: 1679313621
Provider Name (Legal Business Name): LESLYE MONSERRAT HERRERA HERNANDEZ LCASA / LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/28/2024
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3710 UNIVERSITY DR STE 100
DURHAM NC
27707-6208
US
IV. Provider business mailing address
1209 SOUTHGATE DR
RALEIGH NC
27610-5096
US
V. Phone/Fax
- Phone: 919-906-4390
- Fax: 919-287-2707
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | P020615 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | LCAS-30069 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: