Healthcare Provider Details

I. General information

NPI: 1376487074
Provider Name (Legal Business Name): NANCY MCLEOD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 UNITED ST APT 200
GARNER NC
27529-6680
US

IV. Provider business mailing address

100 UNITED ST APT 200
GARNER NC
27529-6680
US

V. Phone/Fax

Practice location:
  • Phone: 919-780-2004
  • Fax: 919-780-2004
Mailing address:
  • Phone: 919-780-2004
  • Fax: 919-780-2004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: